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Aneurysm: Poster from 25 to 81

172 severe prognosis. Two main problems must be urgently faced: the secondary damage caused by intraventricular clot and hydrocephalus, and the risk of early rebleeding. Urgent endoscopic removal of IVH after securing the aneurysm with coiling could solve problems regarding brain damage and recurrence of hemorrhage. Fourteen patients (mean age 34,6±3,7 years) presenting with IVH due to aneurysm rupture, were treated in our department by coiling and endoscopic removal of IVH. All patients underwent endovascular coiling of aneurysms before surgery. A rigid endoscope was introduced into ventricles for evacuation of clots using the sucking drain through working channel. CT scans of brain obtained before (within 12 hours from onset of IVH) and after surgery (within 24 hours) to compare using Graeb score. The outcome was assessed according to Glasgow Outcome Scale (GOS). The procedure resulted in satisfactory removal of IVH: Graeb score was reduced from 10.2±0.4 to 3.6±0.8. Favorable outcome (3-5 GOS grades) was observed in 71.4% cases. Two patients (14.2%) died. No recurrence of hemorrhage was observed during 6 months in the treated patients. The early neuroendoscopic removal of intraventricular hemorrhage after endovascular coiling of ruptured aneurysms is very useful for surgical management of such complex cases, increases the feasibility of the procedure, resulting in a reduced complication rate.