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Use of flexible endoscopic aspiration for an intraventricular small floating clot with hemorrhage: a technical note

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Abstract

Background

Although flexible endoscopy is effective for intraventricular lesions, it is less frequently used for hemorrhagic cases. In some hemorrhagic strokes, blood clots may plunge into the cerebral aqueduct and cause acute obstructive hydrocephalus. A flexible endoscope can aspirate clots and prevent acute hydrocephalus.

Methods

Here, we report four cases of hemorrhage: one of intracerebral hemorrhage and three of subarachnoid hemorrhages.

Results

In all cases, acute hydrocephalus was not apparent upon admission. Sudden comatose occurred; computed tomography revealed acute obstructive hydrocephalus with a strangulated clot in the cerebral aqueduct. We performed aspiration of the strangulated clot using a flexible endoscope. Consciousness improved in all cases, and acute hydrocephalus was prevented in all cases.

Conclusion

The use of simple flexible endoscopic aspiration for clots might be a beneficial and less-invasive procedure for acute obstructive hydrocephalus caused by a small clot with hemorrhagic stroke.

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Correspondence to Hiroaki Neki.

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The authors declare that they have no conflicts of interest.

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This study was approved by the Institutional Review Board of Saitama Cardiovascular and Respiratory Center, Saitama, Japan.

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Informed consent was obtained from the patient.

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Neki, H., Shibata, A., Komine, H. et al. Use of flexible endoscopic aspiration for an intraventricular small floating clot with hemorrhage: a technical note. Neurosurg Rev 44, 2363–2367 (2021). https://doi.org/10.1007/s10143-020-01392-2

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  • DOI: https://doi.org/10.1007/s10143-020-01392-2

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