Usefulness of burr-hole ultrasonography for endoscopic evacuation of intracerebral hematoma

概要

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The endoscopic treatment for neurological disease has become widespread. Recently, endoscopic evacuation of an intracerebral hematoma has been introduced. The advantage of endoscopic treatment is that it is less invasive. However, the surgical field is limited and evaluation of the entire lesion is not possible. Here, we report the usefulness of burr-hole ultrasonography for endoscopic treatment. An ultrasound scanner (ALOKA SSD-2000, Tokyo, Japan) and a small transducer with a bayonet-style handle and a straight, untapered head (ALOKA UST-5268P-5, 3.0-8.0 MHz, phased-array sector probe) were used. After opening a standard burr-hole, the transducer was placed in the operative field and the intracranial lesion was examined. A postoperative computed tomography (CT) scan was obtained in each case to corroborate the appropriate procedures performed with ultrasonography. The endoscopic treatment was performed for two cases of putaminal hemorrhage and one case of cerebellar hemorrhage. Intraoperative ultrasonography provided real-time information about the location, distance, and trajectory of the lesions. Moreover, the removal of the lesion was confirmed. The result of the postoperative CT scan was consistent with findings of intraoperative ultrasonography. No procedure-related complication was noted and the disadvantage was minimal. Intraoperative ultrasonography using a burr-hole transducer has proved to be useful in endoscopic treatment.