Nishihara et al. and Higashi et al. reported on the use of a transparent sheath for neuroendoscopic surgery in the surgical evacuation of intracerebral hematomas in 2000. From June 2000 to November 2002, we performed endoscopic evacuations of hematomas using this transparent sheath in 48 cases of intracerebral hemorrhage. These cases involved 32 putaminal, 9 thalamic, and 7 lobar hemorrhages. Surgical technique and results in cases of putaminal, thalamic, and lobar hemorrhages are reported herein. For putaminal hemorrhage, the mean operative time was 72 min, mean evacuation rate was 82%, and operative complications comprised rebleeding (n = 1) and microarteriovenous malformation (AVM) (n = 1). For thalamic hemorrhage, the mean operative time was 86 min, mean evacuation rate was 76%, and operative complications comprised of intraventricular venous injury (n = 2). For lobar hemorrhage, the mean operative time was 45 min, mean evacuation rate was 82%, and no operative complications were encountered. Endoscopic evacuations of hematomas using transparent sheaths for intracerebral hemorrhages involve less invasive surgery. The important points of this surgery were the position of burr-holes for keyhole surgery and evacuation, and orientation methods when using a transparent sheath. Each putaminal, thalamic, and lobar hemorrhage requires specific techniques for safe and effective surgery. (C) 2003 Elsevier B.V. All rights reserved.
