title: Fully Endoscopic Freehand Evacuation of Spontaneous Supratentorial Intraparenchymal Hemorrhage.
abstract: OBJECTIVE
  A modification of other reported endoscopic techniques for intracerebral clot evacuation is described and illustrated.
  
  
  METHODS
  From January 2014 to December 2014, we operated on 6 patients harboring a spontaneous supratentorial intracerebral hemorrhage using a fully endoscopic freehand technique. Clinical chart and surgical videos were analyzed. Volumetric evaluation of the clot preoperatively and the residual hematoma postoperatively was performed. Clinical outcome was measured using the modified Rankin Scale and Glasgow Outcome Scale.
  
  
  RESULTS
  The mean operative time was 96 minutes (range, 72-125 minutes). Clot evacuation was >90% in all patients. No patient experienced rebleeding after surgery. Two patients died. The Glasgow Outcome Scale score at 6 months was 4 in 2 patients, 3 in 2 patients, and 1 (death) in 2 patients. The modified Rankin Scale score at 6 months was 6 (death) in 2 patients, 4 in 2 patients, 3 in 1 patient and 2 in 1 patient.
  
  
  CONCLUSIONS
  The proposed minimally invasive technique allows a good rate of hematoma evacuation and intraoperative bleeding control. Further studies in large series are needed to confirm the role of this freehand endoscopic technique.
authors.affiliation: Division of Neurosurgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy. Electronic address: fangileri@unime.it.
authors.forename: Filippo Flavio
authors.initials: FF
authors.lastname: Angileri
authors.affiliation: Division of Neurosurgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
authors.forename: Felice
authors.initials: F
authors.lastname: Esposito
authors.affiliation: Division of Neurosurgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
authors.forename: Stefano Maria
authors.initials: SM
authors.lastname: Priola
authors.affiliation: Division of Neurosurgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Raffa
authors.affiliation: Division of Neurosurgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Marino
authors.affiliation: Division of Neurosurgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
authors.forename: Rosaria Viola
authors.initials: RV
authors.lastname: Abbritti
authors.affiliation: Division of Neurosurgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Giusa
authors.affiliation: Division of Neurosurgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Germanò
authors.affiliation: Division of Neurosurgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Tomasello
mesh_terms: D000368:Aged; D002543:Cerebral Hemorrhage / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D017809:Fatal Outcome; D005260:Female; D015600:Glasgow Coma Scale; D023261:Glasgow Outcome Scale; D006406:Hematoma / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D044583:Neuroendoscopy / Q000379:methods*; D020127:Recovery of Function; D016896:Treatment Outcome
keywords: Endoscopic management; Intraparenchymal hemorrhage; Stroke; Surgical treatment