Transaqueductal aspiration of pontine hemorrhage with the aid of a neuroendoscope

The authors advocate the use of a 1.7-mm fiberscope to evaluate a hypertensive bilateral tegmental pontine hemorrhage that has ruptured, in part, into the fourth ventricle. In applying this new technique, a fiberscope, which contains a guide tube in the working channel, is inserted into the aqueduct. After the endoscope has been removed, a silicone tube is slid along the guide tube. The hematoma is evacuated through the silicone tube and a potassium titanyl phosphate laser is used to achieve hemostasis.