RESUMO
Objective To study the surgical indication,surgical method and effectiveness of endoscope-assisted microscopic surgery for brainstem hemorrhage with hematoma breaking into the forth ventricle.Methods Eleven patients having brainstem hemorrhage with hematoma breaking into the forth ventricle,admitted to our hospital from October 2002 to February 2012 and performed endoscope-assisted microscopic surgery via suboccipital trans-fourth ventricle approach,were chosen in our study; retrospective analysis of their clinical data and outcomes was performed.Results Postoperative CT scan on all 11 patients showed that 87.2％-98.9％ (average 94.3％) of the brainstem hematomas in volume were removed.Follow up for 4 months to 2 years showed that neurological outcome improved significantly in 2 patients,moderate disability in 3 patients,severe disability in 2 patients and vegetative state in 1 patient.Three patients died.Conclusion Endoscope-assisted microscopic surgery of brainstem hemorrhage with hematoma breaking into the forth ventricle is minimally invasive and effective with direct-vision; it also improve good neurological outcomes.