Abstract
Background Intraventricular extension of a parenchymal hemorrhage is an independent predictor
of poor outcome and might be complicated by delayed hydrocephalus. We describe a method
for the rapid and effective removal of a lateral ventricular hematoma via catheter-based
puncture and aspiration.
Methods A catheter-based aspiration of a ventricular hematoma via a frontal eminence (FE)
puncture was performed in 10 patients with thalamic and ganglionic hemorrhage perforating
into the lateral ventricle. Paralleling the long axis of the lateral ventricle, a
flexible silicone catheter was moved anteroposteriorly and rotated simultaneously
to facilitate clot aspiration and removal. Computed tomography scans before and after
surgery were compared for assessment of ventricular clot volume, Graeb score, and
the ventriculocranial ratio (VCR). The Glasgow Coma Scale (GCS) score and Glasgow
Outcome Scale (GOS) score were assessed at 14 days and 12 months following surgery,
respectively.
Results In all 10 patients, catheter-based aspiration resulted in substantial hematoma removal
with a clearance rate of 64.9%, a reduced Graeb score by 61.8%, and an elevated GCS
score by 52.7%. The procedure was performed safely without occurrence of another hemorrhage,
infection, and catheter obstruction in any case. At 12-month follow-up, VCR was reduced
by 22.5%, no delayed hydrocephalus occurred, and a favorable outcome with an average
GOS of 4.6 was observed in this small cohort of patients.
Conclusion Catheter-based aspiration of a ventricular hematoma via FE puncture rapidly, efficiently,
and safely reduced the clot in the ventricular system, prevented delayed hydrocephalus
sufficiently, and produced a favorable outcome.
Keywords
aspiration - external ventricular drainage - frontal eminence - intraventricular hemorrhage
