الفهرس 
Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Intraventricular hemorrhage (IVH) is one of the serious central nervous system hemorrhagic diseases. It may occur as a primary condition (Primary IVH) or secondary to intracerebral hemorrhage (ICH) extending into the ventricles (secondary IVH) (1), (2).
The typical clinical presentation of IVH include headache, disturbed consciousness, disturbance of water and electrolyte balance, limb dysfunction, dystonia and high disability and mortality rate. The mortality rate in patients with severe IVH is as high as 80 % (3).
Increased intracranial pressure associated with IVH is usually managed both medically and surgically. Traditional medical treatment cannot effectively relieve increased intracranial pressure usually with poor outcome. A combination of extraventricular drainage (EVD) with thrombolytic agents is widely used. However, prolonged catheterization and injection may cause intracranial infection that can result in hydrocephalus. Also, there is a high incidence of rebleeding. (5) .
In patients with severe IVH, neuroendoscopic hematoma evacuation in conjunction with intraventricular lavage demonstrated clearly favorable effects. It is advantageous to the prognosis of patients with severe IVH and can substantially enhance the perioperative state and hematoma clearance rate (71).
The aim of this study was to evaluate endoscopic intraventricular hematoma lavage surgery regarding surgical technique, outcome and complications.
This study was conducted on twenty adult patients suffering from intraventricular hemorrhage (IVH) from March 2022 to March 2023 who were treated by neuroendoscopic ventricular lavage with insertion of external ventricular drain (EVD) and they were followed for 3 months postoperatively both clinically and radiologically.
The mean age group in this study was (51 ± 12.3) years. Predisposing factors for IVH were hypertension, diabetes, smoking, tumors, aneurysm and trauma.
The mean preoperative Glasgow coma score (GCS) was 9.6 ± 1.8 while the mean GCS at the end of 3 months postoperatively was 13.9 ± 1.8 and the difference was statistically significant (p<0.05).
Clinical and laboratory parameters were recorded, the Radiological characteristics of hematoma was measured and scaled on Graeb grading score.
The mean operative time was 2.2 ± 0.3 hours and the mean hospital stay was 21 ± 5.31 days.
General complications encountered during this study included pneumonia in 30%, urinary tract infection (UTI) in 35%, deep vein thrombosis in 20% and bed sores in (5%).
Procedure related complications included catheter occlusion in 30% of patients, catheter rebleeding in 25% of patients, ventriculitis in 15% of patients, chronic hydrocephalus in 30% of patients and brain herniation in 10% of patients.
The final outcome of this study at the end of 3 months postoperatively included excellent outcome (complete recovery) in 25% of patients, good outcome (moderate to severe disability) in 25% of patients and poor outcome(death) in 40% of patients with 2 patients in vegetative state (10%).