内镜经枕天幕-松果体隐窝-上髓帆入路清除全脑室血肿OA

Objective To explore the feasibility and clinical efficacy of endoscopic hematoma evacuation via transoccipital tentorium-pineal recess-superior medullary velum approach for whole ventricular hematoma.Methods A retrospective analysis was conducted on one case of thalamic hemorrhage rupturing into the ventricles admitted to the Department of Neurosurgery,Suzhou Ninth Hospital Affiliated to Soochow University in November 2024.Hematomas in the thalamus and entire ventricles were evacuated via the endoscopic transoccipital tentorium-pineal recess-superior medullary velum approach.Results The endoscopic transoccipital tentorium-pineal recess-superior medullary velum approach allowed direct evacuation of hematomas in the thalamus and whole ventricular system.Early establishment of cerebrospinal fluid circulation improved patients'conscious disturbance rapidly.No external ventricular drainage was conducted.No postoperative complications such as rebleeding,hydrocephalus and intracranial infection were observed.Favorable hematoma clearance and clinical efficacy were obtained.Conclusions The endoscopic transoccipital tentorium-pineal recess-superior medullary velum approach avoids external ventricular drainage and intraventricular urokinase injection.It possesses potential clinical advantages and deserves further application and promotion.