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Objective:To explore the value of application and manipulation technique of neuroendoscope in microsurgical clipping of ruptured posterior communicating artery(PCoA)aneurysms via keyhole approaches.Methods:From January 2018 to December 2020, the clinical data of 52 patients who received microsurgical clipping for ruptured via keyhole approach were retrospectively analysed. Forty-one patients had the intraoperative endoscopic monitoring. The supraorbital keyhole approach or pterional keyhole approach was applied based on the characteristics of the aneurysms. According to the in-surgery requirement, a 30° rigid neuroendoscope was used before and/or after clipping. All patients entered postoperative follow-up in outpatient clinic and were evaluated with the modified Rankin Scale(mRS).Results:All 52 patients had 52 ruptured PCoA aneurysms. Eighteen of the patients were treated via supraorbital keyhole approach and 34 via pterion keyhole approach. Pre-and post-clipping endoscopic observation were carried out in 12 cases and 29 only with post-clipping endoscopic observation. Residual aneurysmal neck was detected in 3 patients. Missed clipping of perforators was found in 2 patients and followed by proper adjustment of clips. All patients received follow-up angiographic examinations. Total obliteration of the aneurysm and an intact of internal carotid artery and PCoA were found in 41 patients by the intraoperative endoscopic observation. Two residual aneurysmal neck were detected in 11 patients without intraoperative endoscopic observation. After 11 to 45 months of follow-up, all patients had good recovery(mRS 0-1).Conclusion:It is a safe and effective method with endoscopic observation during microsurgical clipping procedure for ruptured PCoA aneurysms via keyhole approaches. It can effectively make up for the insufficient visual angle of microscope, realise the anatomical relationship between the aneurysm and adjacent structures, and avoid residual aneurysmal neck and an iatrogenic injury to the parent artery and perforators.
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Background: Chronic kidney disease (CKD) is a clinical syndrome due to irreversible renal dysfunction leading to excretory, metabolic and synthetic failure culminating into accumulation of non-protein nitrogenous substances and present with various clinical manifestations. Elevated circulating concentrations of CRP are a common phenomenon in ESRD patients. The prevalence and magnitude of inflammation increases as renal function declines.Methods: The current cross-sectional observation study was conducted in Rajendra institute of medical sciences, Ranchi during study period October 2015 to September 2017 on admitted patients with chronic kidney disease. 90 patients of different age groups between 16-75 years were enrolled in the study. Samples were selected by using simple random sampling method. Informed consent was obtained from all the patients.Results: 85.6% of the patients studied were males and 14.4% of the patients were females. Most cases of CKD were associated with hypertension (77.8%) out of which there were 62 males and 8 females, followed by DM (25.5%) where there were 20 males and 3 females. 44.4% cases had an elevated level of hs-CRP (more than 3 mg/L) while 55.6% patients had hs-CRP below 3 mg/l. Out of 40 high hs-CRP patients, 35 were male and 5 were female. Patients with elevated creatinine level had significant high hs-CRP level.Conclusions: Chronic kidney diseases, Cardiovascular disease, HS-CRP, Inflammation
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Objective To investigate the effect of navigation assisted neuroendoscope hard channel technology for treating hypertensive cerebral hemorrhage in basal ganglia region.Methods Eighty-two inpatients with hypertensive cerebral hemorrhage in basal ganglia region treated in this hospital were selected as the study subjects,among them 37 cases adopted the neuroendoscope hard channel technology and 45 cases adopted the small bone window craniotomy.The operation time,intraoperative bleeding vol-ume,hematoma clearance rate,postoperative complication occurrence rate and NIHSS score at postoperative 3 months were com-pared between the two groups.Results Compared with the bone window group,the operative time in the endoscopic group was lon-ger and the hematoma clearance rate was higher,intracranial rebleeding occurrence rate was lower and the short term prognosis was better(P<0.05).The aspects of intraoperative bleeding volume and other postoperative complications had no statistically signifi-cant difference between the two groups(P> 0.05).Conclusion The navigation assisted neuroendoscope hard channel technology can improve the cure rate in the patients with hypertensive cerebral hemorrhage in basal ganglia region.
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Objective The aim of our study was to establish an endoscopic endonasal transsphenoidal surgical training model, and to examine its application value. Methods The endoscopic endonasal transsphenoidal surgical training models were made.After assessments,the models was used for endoscopic operation training for 8 neurosurgeons with no experiences of endoscopic operation. Results The available operating space of this model is similar to the actual operating space in endoscopic endonasal transsphenoidal surgery. The egg fixed on the model has many layers of structure, such as eggshell, shell membrane, egg white and egg yolk, which constituted a good practice object. All students indicated that they could benefit from the training using this model. The skill in grinding the eggshell [(1.07 ± 0.221)cm2/min vs.(1.45±0.27)cm2/min, P<0.001]was significantly improved and the chance for shell membrane rupture (8 vs. 2, P=0.007) was significantly reduced in the last-time practice compared with the first-time practice (P<0.001). Conclusion The endoscopic endonasal transsphenoidal surgical training model is helpful for neurosurgeons to practice the basic operation of endoscopic surgery and to improve their surgical skills,and can be used repeatedly.It can be used in basic operation training before the training using cadaver cranium.
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Objective To study the anatomic characteristics and clinical values of the internal auditory artery via the neuroendoscope and microscope.Methods We observed the related microdissection of the internal auditory artery of 15 cadavers through retrosigmoid approach by operative microscope and neuroendoscope,in which 3 cadavers were fresh.Results The internal auditory arteries were observed bilaterally in all specimens (100％).Among them,17 sides (56.7％,17/30) were isolated branch type,9 sides were dual trunk (30％,9/30),and 4 sides were three branches type (13.3％,4/30).The diameter of the vessel at its origin was 0.12～0.28 mm,the average caliber of IAA was 0.22±0.04 mm,the length of IAA ranged from 7.12 to 14.82 mm,and the Mean 10.18± 2.63 mm.The starting-point of IAA was quite variable,13.3％ (4/30) of the IAA origined from the inferior segment of the basilar artery,and 86.7 ％(26/30) of the IAA origined from ACIA.Among them,17 sides (65.4％,17/26) of the IAA origined from the ansa of the inferior cerebellar artery,9 sides (34.6％,9/26) of the IAA origined from the anterior inferior cerebellar artery involved in the inner ear canal.We observed that 73.3 ％(22/30) of the IAA branches were along the ventral side of the vestibulocochlear nerve;26.7 ％(8/30) of the IAA branches were above the nerves.It's easy to identify the IAA and its adjacent structures by various neuroendoscope through various anatomic fissures.Conclusion Most of internal auditory arterys were located anterior and posterior to the facial nerve,the microscope was impossible to see it directly.A thorough identification of the internal auditory artery requires theuse of both surgical microscopy and neuroendoscope.
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Objective To explore the surgical techniques of transsphenoidal approach neuroendoscope-assisted sella turcica tumor resection. Methods The clinical data of 71 patients who had underwent transsphenoidal approach neuroendoscope-assisted sella turcica tumor resection were retrospectively analyzed. Results Among the 71 patients, pituitary tumors was in 67 cases (including recurrent pituitary tumors 4 cases), and Rathke cysts in 4 cases. A total of 54 cases had gross total resection, 10 cases had near total resection, and 7 cases had subtotal resection. Some patients had postoperative complications, including transient diabetes insipidus in 16 cases, refractory hyponatremia in 2 cases,cerebrospinal rhinorrhea in 1 case,hypothyroidism in 1 case,rhinorrhagia and synechia nasal in 1 case, hyposmia in 4 cases, and perioperative cerebral infarction in 1 case. There was no surgery related death. After 3 months' follow- up, 12 cases were found to have nasal mucosa atrophy. Conclusions The transsphenoidal approach neuroendoscope-assisted sella turcica tumor resection is safe and effective, with less serious complications, but the complications of nasal cavity should not be ignored.
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Objective To discuss the clinical efficacy of surgery for chronic subdural hematoma assisted by rigid neuroendoscope and its surgical techniques. Methods Clinical data of 161 patients with chronic subdural hematoma from August 2009 to December 2015 was analyzed retrospectively. 74 of them experienced surgeries assisted by rigid neuroendoscope (endoscope group) and other 87 cases were operated without neuroendoscope (routine group) during the same period. Results Although there were significant difference in operative duration between the two groups, complications, ratio of total removal of hematoma after surgery, postoperative inpatient duration and recurrent rate of hematoma were more advantageous in endoscope group. The operative duration of endoscope group with (112.68 ± 34.86) min was longer than that of routine group with (74.11 ± 28.23) min (t = 7.75, P = 0.000), while the postoperative inpatient duration of endoscope group with (8.23 ± 2.01) d was shorter than that of another group with (10.79 ± 5.02) d (t = -4.12, P = 0.000). There were no surgical associated complications in endoscope group, but 1 patient in routine group experienced intracerebral hematoma of frontal lobe and associated aphemia. Total removal of hematoma was confirmed in endoscope group with 98.65% (73/74), which was higher than that in routine group with 86.21% (75/78) (χ2 = 8.34, P = 0.004). Hematoma recurrence was found in 16 cases of routine group (18.39%), but more superiority in endoscope group with 1.35% (χ2 = 12.29, P = 0.000). Outpatient follow-up was carried out in all patients from 6 to 38 months with an average duration of 30.06 months. In 17 cases with recurrent hematoma during follow-up, 15 of them were cured by a second surgery, and another 2 patients were cured by atorvastatin. Conclusion As a simple, safe and effective technique, the application of rigid neuroendoscope during surgery for chronic subdural hematoma is more advantage than routine surgery. A self-made suction with adjustable soft curved tip is suitable for such procedure.
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Objective To compare the efficacy of neuroendoscopic vs microscopic endonasal transsphenoidal pituitary adenoma resection and effects on hormone levels and clinical symptoms. Methods A retrospective analysis was conducted on 211 cases with pituitary tumor resection patients from January 2012 to June 2016, of which 112 cases with endoscopic endonasal transsphenoidal pituitary tumor resection (group A), 99 cases with microscopic transsphenoidal pituitary tumor resection (group B), and operation related indexes, hormone variations before discharge and symptoms remission 24 weeks after operation were extracted and compared. Results Two groups of patients with different tumor resection extent (Z = 2.14, P = 0.032), group A achieved total resection rate was significantly higher than the group B (79.5% vs 67.7%) (P = 0.037); the operation time of group A was significantly longer than group B [(93.6 ± 26.7) vs (79.8 ± 20.2) min, t = 4.26, P = 0.000], group A with the mean hospitalization stay was significantly less than group B [(7.9 ± 2.5) vs (10.2 ± 4.3) d, t = 4.67, P = 0.000], postoperative complications of group A were significantly lower than those of group B (5.4% vs 14.1%, χ2 = 4.73, P = 0.030). Two groups of postoperative hormone levels decreased in different degree (Z = 2.42, P = 0.016), group A with hormone recovery rate before discharge was significantly higher than group B (82.2% vs 66.7%, χ2 = 6.09, P = 0.014), and decline on prolactinomas, ACTH adenoma, ghrelin hormone were significantly higher than group B [(43.2 ± 10.5) vs (33.5 ± 9.1) ng/ml, (26.0 ± 8.8) vs (20.2 ± 7.0) pmol/L, (11.0 ± 3.9) vs (8.7 ± 3.2) μg/L, t = 3.60, t = 2.65, t = 2.12, all P < 0.05]. There was no significant differences between the two groups in remission of clinical symptoms 24 weeks after operation (P > 0.05). Conclusion Neuroendoscopic endonasal transsphenoidal pituitary adenoma resection is more efficient and less operative complications compared with microscopic surgery, which is more conducive to the recovery of postoperative hormone levels.
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Midbrain gliomas are relatively rare neoplasms with a generally benign prognosis, with dissemination or metastasis not previously reported. We describe here a woman, in whom magnetic resonance imaging scans showed hydrocephalus and a tegmental lesion in the upper aqueduct. Endoscopic third ventriculostomy and biopsy were performed; during surgery, a second small lesion was observed in the infundibular recess. Histologically, the two lesions had the characteristics of low grade astrocytoma, suggesting that the midbrain astrocytoma may have been disseminated via the cerebral spinal fluid to the infundibular recess. Postoperatively this patient received radiotherapy for nearly one month. Although patients with these tumors are not usually administered adjunctive therapy, radiation and, combined modality therapy, including surgery, radiotherapy, and chemotherapy, may be beneficial in patients with midbrain gliomas with dissemination.
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Adult , Female , Humans , Astrocytoma , Biopsy , Cerebrospinal Fluid , Combined Modality Therapy , Drug Therapy , Glioma , Hydrocephalus , Magnetic Resonance Imaging , Mesencephalon , Neoplasm Metastasis , Neuroendoscopes , Prognosis , Radiotherapy , VentriculostomyABSTRACT
An exoscope, high-definition video telescope operating monitor system to perform microsurgery has recently been proposed an alternative to the operating microscope. It enables surgeons to complete the operation assistance by visualizing magnified images on a display. The strong points of exoscope are the wide field of view and deep focus. It minimized the need for repositioning and refocusing during the procedure. On the other hand, limitation of magnifying object was an emphasizing weak point. The procedures are performed under 2D motion images with a visual perception through dynamic cue and stereoscopically viewing corresponding to the motion parallax. Nevertheless, stereopsis is required to improve hand and eye coordination for high precision works. Consequently novel 3D high-definition operating scopes with various mechanical designs have been developed according to recent high-tech innovations in a digital surgical technology. It will set the stage for the next generation in digital image based neurosurgery.
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Cues , Depth Perception , Hand , Microsurgery , Neuroendoscopes , Neurosurgery , Surgeons , Telescopes , Visual PerceptionABSTRACT
Objective To investigate the differences of efficacy and economic efficiency between neuroendoscope and microscope for intracerebral hematomas cleaning operation. Methods From August 2014 to August 2015, clinical data of 68 cases with intracerebral hemorrhage were analyzed retrospectively. Hematoma evacuation was carried out by microscope in 37 cases (microscope group) received and 31 cases (endoscope group) underwent neuroendoscope. Following parameters were compared: the operation related index (hematoma clearance rate , intraoperative blood loss , the operation time , skin incision , bone window size ) , Glasgow Outcome Scale at 6 months after the operation, complications (intracranial infection, lung infections, gastrointestinal bleeding), medical economic parameters (the postoperative hospital stay, drug cost, cost other than drug, and total hospital cost). Results The hematoma clearance rate, Glasgow Outcome Scale at 6 months after the operation in the endoscope group were significantly better than those in the microscope group (P 0.05). The postoperative hospital stay, drug costs , no drug costs , and total hospital cost were significantly less in neuroendoscope group than that in microscope group (P< 0.01). Conclusion Neuroendoscopy has less trauma,there are some advantages of neuroendoscopy for intracerebral hematomas cleaning operation , such as minimal trauma , prominent effect , good prognosis and low cost. It should be widely applied in clinical practice.
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Objective To investigate the anatomic landmarks during the exposure of thalamus via the transcorpus callosal ventricle approach between microscope and endoscope to provide an anatomic foundation for clinical application. Methods The transcorpus callosal ventricle approach to expose the thalamus was simulated in selected 6 (12 sides) red and blue latex-perfused cadaver head specimens. The anatomic structures of four stages-interhemispheric, septum pellu?cidum cavity, lateral ventricle and third ventricle were examined by microscope and endoscope and relevant anatomic date was obtained during the process. Results Both microscope and endoscope could show the anatomic structures clear?ly during the interhemispheric and septum pellucidum cavity stages. The major landmarks of the interhemispheric cavity included callosal margin artery, cingulate sulcus, pericallosal artery and corpus callosum, and landmarks of septum pellu?cidum cavity included the septum pellucidum and body of fornix. Lateral ventricle stage-the major landmarks contained foramen of monro, septum vein, thalamus striatum vein, choroid plexus, body of fornix and body of caudate nucleus. The blind field under microscope such as anterior part of frontal horn (25.7mm±1.7mm vs. 14.2mm±1.2mm, P<0.05), lateral part (1/3) (12.1mm ± 0.7mm vs. 7.0mm ± 0.9mm, P<0.05) and posterior part (2/5) (28.8mm ± 1.4mm vs. 18.7mm ± 1.4mm, P<0.05) of thalamus could be made up by endoscope. Third ventricle stage-neither microscope nor endoscope could show the medial part of thalamus effectively due to the restriction of fornix and internal cerebral vein. Conclusions The anatomic landmarks can be identified during the exposure of thalamus via the transcorpus callosal ventricle approach. The coordination of microscope and endoscope can be helpful to identify eloquent structures and make up blind surgical field.
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ObjectiveTo discuss the application of neurophysiological monitoring (NEPM), intraoperative color Doppler ultrasonography, fluorescein angiography and neuroendoscope in clinical effects of intracranial giant aneurysm microsurgey. MethodsTo retrospectively review the clinical data of 17 intracranial giant aneurysm. Pre-operative imaging were used, including 3D- CTA, MRI and DSA, to make dectection and delineation of the aneurysm.The NEPM to evaluate the nerve function,assess the qualitative and quantitative flow rate of aneurysm and surrounding blood vessels by Doppler ultrasonography and fluorescein angiography,and reveal opography of aneurysm,protect the considerable perf.vessels and nerves by neuroendoscope.Operative techniques were used including parent artery control,aneurysm neck forming,aneurysm decompression and resection,obliteration of aneurysm with multiple clips and vasospasm protection.Results Seventeen cases of giant aneurysms were clipped successfully under muti-technology, follow-up demonstrated excellent neurological outcomes in 15 cases, one case had mild disability, one case had severe disability, no dead cases. DSA showed clipping completely, parent artery clear, and long-term follow-up was still in progress.Conclusion Multi-technology combined microsurgical techniques which can effective improve the outcomes of intracranial giant aneurysms.
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Objective To compraison the of exposure in the endonasal transsphenoidal approach to the sellar between microscope and endoscope. Methods Ten formalin-fixed, silicone-injected adult cadveric heads were studied. A direct endonasal transsphenoidal approach was performed via the right nostril, pushing aside the nasal septum, then reach the sphenoidal sinus. The approach was performed with the operating microscope first, then with the endoscope. For each step (sellar, suprasellar, parasellar and clival), the operative region afforded by direct microscopic view was measured and then compared with that obtained by using the edndoscope. Results It was found that the endoscope provided greater view than microscope in this approach. Although the microscope provides an adequate view of the midline structures and part of the contralateral parasellar areas; under direct endoscopic vision, the lateral extension could be widened by an additional 6.5 mm on the ipsilateral and 4 mm on the contralateral side. At suprasellar region, the microscope provides could expose the posterior part of, optic nerve and optic chiasma; but could not expose the areas anterior and superior the interspace superior the optic chiasma. Compare with the microscope, the endoscope allowed extension of bone removal and dual opening for an additional 4 mm anteriorly at the sagittal axis and an additional 3.5 mm on the ipsilateral and 4 mm on the contralateral side. At the clivus region, the medial surface of the vertical segment of the ICA and the basilar artery could be partially 7 exposed by the microscope. By the endoscope, it could gain an additional 4 mm on the ipsilateral side and 2.5 mm on the contralateral side in width. Because of the anatomical boundaries of the sphenoid sinus, the anatomincal exposure by the microscope same as the endocope at the sagittal axis. Conclusion The endoscope allows for a panoramic view and permits widening of the operative exposure in all directions. The endoscope is more suitable in the the minimal and expanded endonasal transsphenoial approach.
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@#Objective To explore the microsurgical technique and clinical value of endoscope-assisted microsurgery via the transsphe-noidal approach to the clivus. Methods According to the results of microanatomy of endoscope-assisted via the transsphenoidal approach to sellar and clival area, the clinical data of 12 cases (8 with invasive pituitary adenoma, 3 with chordoma, 1 with chondroma) treated by transsphenoidal approach were studied retrospectively. All cases were followed-up 3 months to 6 years after operation. Results The tumor was totally removed in 8 patients, removed subtotally in 3 patients, and removed partially in 1 patient. 6 patients occurred transient diabetes insipidus, 2 patients with transient cerebrospinal rhinorrhoea. There were no death or intracranial infection. Postoperative follow-up was performed for 3 months to 6 years, No recurrence occurred except for enlargement of 1 chordoma. Conclusion Transsphenoidal approach satisfactorily and quickly reaches and helps remove the larger tumors in sellar and clival area without severe complication. It has the advantages of low incidence of surgical complication and high total removal rate. Endoscope-assisted may be helpful for this approach.
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Objective To explore the effect and technical skills of neruoendoscope-assisted microneurosurgery via the supraorbital keyhole apporach for giant olfactory groove meningiomas.Methods A total of 12 patients with giant olfactory groove meningiomas(≥7 cm in diameter)received neruoendoscope-assisted microneurosurgery via the supraorbital keyhole approach.Data of the patients were analyzed retrospectively.Results Among the cases,9 achieved complete resection of the tumor,inlcuding 5 cases of SimpsonⅠ and 4 cases of Simpson Ⅱ.The other 3(Simpson Ⅲ)patients underwent subtotal resection.None of the patients died during the operation.Ten of the patients were follwed up for 3 months to 2 years(mean,14 months).During the follow-up,9 of the 10 resumed physical and sporting activities,and the other one retured to normal daily life.MRI examination was prefomred on 9 patients,none of them had recurrence.Conclusions Neruoendoscope-assisted microneurosurgery via the supraorbital keyhole approach is effective and safe for patient with giant olfactory groove meningioma.The tumor should be removed piece by piece during the operation.
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Over the last decades, the use of endoscope in neurosurgery gradually gained importance. Although the major indication of neuroendoscopic procedure is intraventricular procedures, the experience of neuroendoscopic intervention of intraventricular hemathoma is rather small. The authors present our experience of four patients with acute ventricular dilatation with intraventricular hematoma through frame-based stereotactic guidance. Through neuroendoscopic intervention, the clot was removed more than 80% each procedure. After the procedure, the silastic catheter was left for continuous intraventricular pressure monitoring. Neither thrombolytic agent nor hyperosmolar treatment was needed postoperatively. There was no mortality or morbidity directly related to endoscopic procedure itself. Brief overview of this technique is given.
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Humans , Catheters , Dilatation , Endoscopes , Hematoma , Mortality , Neuroendoscopes , Neurosurgery , Ventricular PressureABSTRACT
Objective To study the clinical application anatomy of interventricular foramen and offer a base for operation.Methods Interventricular foramens were observed in 15 adult cadaveric brainThirty- two patients of obstructive hydrocephalus were operated to observe the structure of interventricular foramen un- der neuroendoscope.Results Interventricular foramen was a poriform structure which consists of fornixan- terior pole of thalamencephalon and choroid plexus and was a oval shape in most of themThe plane of the fo- ramen was a included angle with the median sagittal planeThe septal veinthalamostriate veinthalamen- cephal and even the floor of third ventricle could be observed clearly in endoscope.At the same timewe found the foramen had a significant change in obstructive hydrocephalus.Conclusion The interventricular foramen has a simple relatively structure but a variation on size and shape especially in obstructive hydroceph- alusA clearly comprehension of it's structure and adjacent is a base to microsurgery and endoscopic surgery on the foramen.
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Objective To explore the methods and techniques of the treatment for epidermoid cyst with endoscope assisted keyhole approach microneurosurgery Methods Sixteen patients with epidermoid cyst were treated with endoscope assisted keyhole approach microneurosurgery Different keyhole approaches were selected according to the position of the tumors With microneurosurgery,larger part of tumor was resected,then under neuroendoscope remains of tumors was found out and removed Result After the tumor were removed with microneurosurgery,the remains of tumors in 13 cases (81 25%) were still found under endoscope,and were resected with endoscope;the remains of tumors in 3 cases were not found Total excision of tumor was achieved in 14 patients (87 5%);Two patients subtotal excision Fifteen cases (93 75%) with clinical symptom had an improvement or recovery 2 weeks operation One case occurred nor bacterial meningitis and recovery 2 weeks after treatment Hydrocephelar and second intracranial hematoma were not found in all patients Following up was carried out for 10 patients after 3 12 months Nine patients got a good result One patient with trigeminal neuralgia Conclusion Endoscope assisted keyhole approach microneurosurgery can increase the total resection rate for epidermoid cyst,reduce the trauma of operation and reaction after operation [Key words] Epidermoid cyst; Intracranial; Neuroendoscope; Keyhole; Microneurosurgery
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Objective To investigate the new therapy for primary intraventricular hemorrhage (PIH).Methods 31 cases of PIH were treated by rigid neuroendoscopy.The cases were composed of 16 cases of single intraventricular hemorrhage,14 cases of double intraventricular hemorrhage and 1 case the third-fourth intraventricular hemorrhage.24 cases were accompanied with acute obstructive hydrocephalus.Results Duration of operation lasted from 30 minutes to 60 minutes, with an average time of 43.4 minutes.More than 90 percent of hemorrhage in 24 cases with single or double intraventricular hemorrhage were evacuated. 50 percent to 90 percent of hemorrhage were evacuated in other 7 cases. Neurological status was obviously improved and improved in 25 cases, no change in 4 cases and dead in 2 cases.Only one patient developed hydrocephalus.Conclusion Neuroendoscopic neurosurgy for PIH was characterized by visualized manipulation, shorten operative time,minimal invasion, effective hemorrhage evacuation and excellent post-operative outcomes.