Modern principles of stereotactic neurosurgery of nontraumatic intracerebral hematomas: a literature review

Abstract

The history and stages of development of modern stereotactic neurosurgery are outlined below. Introduction of CT allowed surgeon to apply stereotactic method at surgery of nontraumatic intracerebral hematomas (NTIH). Blood clots are shattered by mean of Archimedes’ coil or local enzymatic fibrinolysis (instillation of urokinase or tissue plasminogen activator). Stereotactic endoscope-assisted removal of NTIH shows similar efficacy to abovementioned method: grade of functional recovery and mortality levels were similar. Some cases demand simultaneous application of 2 abovementioned methods – by means of stereotactic method NTIH is localized followed by “open” removal of NTIH. Application of stereotactic method allowed us to decrease traumatization of underlying tissues during the surgery, this method complies with the general principles of minimal invasive neurosurgery.