To explore the clinical effect of neuroendoscope combined with Viewsite brain retractor in the treatment of severe intraventricular hemorrhage (IVH) casting.

Twenty-six patients with severe IVH cast treated in the Neurosurgery Department of the 901^st Hospital of the Joint Logistics Support Force of PLA from January 2018 to January 2021 were analyzed retrospectively. Among them, 12 patients underwent neuroendoscopy combined with Viewsite brain retractor through the lateral ventricular frontal angle approach to remove intraventricular hematoma as the operation group; 14 patients were treated with lateral ventricle frontal angle drilling and external drainage as the control group. The postoperative hematoma clearance rate at 6 h and 3 d, postoperative 6 h Graeb scores, changes in the ventricular-cranial cavity ratio (VCR), drainage tube retention time, mannitol dosage and duration, length of stay in neurointensive care unit (NICU) hospitalization and changes in postoperative 14 d GCS scores were compared between the two groups. Furthermore, the incidence of postoperative complications (rebleeding, pulmonary infection, intracranial infection, and delayed hydrocephalus) were compared between the two groups. Postoperative follow-up for 6 months, and the degree of frontal function impairment was assessed by modified Rankin scale (mRs) and frontal lobe frontal assessment battery (FAB) scores.

Compared with the control group, patients in the operation group had less residual hematoma, the Graeb score and VCR value at 6 h after operation were reduced, the indwelling time of drainage tube was shortened; the use of mannitol was reduced, the length of stay in NICU was shortened; the GCS score was improved at 2 weeks after operation; the incidence of postoperative complications (including intracranial infection and delayed hydrocephalus) was reduced, and the mRs neurological function score was improved at 6 months after operation, the differences were all statistically significant (P<0.05). There was no significant difference in the incidence of postoperative rebleeding, pulmonary infection and FAB score between the two groups (P>0.05).

Neuroendoscopy combined with Viewsite brain retractor for the treatment of severe IVH cast can clear the intraventricular hematoma early and quickly, achieve ventricular recanalization early, reduce the passive expansion of the ventricular system, and improve the quality of life of patients.