Neuroendoscopic lavage of ventricular haemorrhage
https://www.neuroendo.net/wp-content/uploads/2018/10/Neuroendoscopic-lavage-of-ventricular-haemorrhage.jpg 560 560 Ulrich-Wilhem Thomale Ulrich-Wilhem Thomale http://www.neuroendo.net/wp-content/uploads/2018/10/avatar_user_10_1539167362-96x96.jpgNeuroendoscopic lavage of ventricular haemorrhage
Diagnosis: Post-haemorrhagic hydrocephalus due to neonatal Intra-Ventricular Haemorrhage
- 41-week gestation female
- IVH at day 1
- MR scan: large intraventricular haematomas in both lateral ventricles
- At 34 days she developed hydrocephalus. US showed ventricular dilatation. She deteriorated clinically (bradycardia, increased head circumference)
- Endoscopic lavage performed
- No need for shunt
EQUIPMENT USED
- Aesculap Minop endoscope, 0o lens (an endoscope with two additional channels beside the working channel is needed, for simultaneous irrigation and aspiration)
SURGICAL TIPS
- Approach to the lateral ventricle where the clot is located (right)
- Burr hole placed more lateral than usual, to allow septostomy
- US guidance for inserting the endoscope
- Septostomy to gain access to the opposite lateral ventricle
- Continuous irrigation with warm (37o C) Ringer’s solution, lactate-free; up to 3 lt may be required
- Passive outflow to avoid uncontrolled ICP increase
- Gentle aspiration of clots with the outflow channel of the endoscope
- Reservoir placement at the end of the procedure
- Average operation time: 70 minutes
Pre op
Post op
