• Georgios Alexopoulos, Michael Prim, Maheen Khan, Nabiha Quadri, Jorge F Urquiaga, Najib El Tecle, and Jeroen Coppens.
• Department of Neurosurgery, Saint Louis University Hospital, St. Louis, Missouri, USA. Electronic address: alexopoulos_george@hotmail.com.
• World Neurosurg. 2020 Feb 1; 134: e540-e548.

ObjectiveWe present the application of the BrainPath endoport-assisted microsurgical device (EAMD) as a treatment modality for patients with severe intraventricular hemorrhage (IVH) secondary to spontaneous supratentorial intracerebral hemorrhage (sICH).MethodsPatients with severe secondary IVH (defined as Graeb score [GS] >6) who presented to Saint Louis University Hospital, St. Louis, Missouri, United States, from 2017 to 2019 were treated with the minimally invasive approach for IVH evacuation using the atraumatic BrainPath aspiration system.ResultsThree patients (2 men and 1 woman) with a mean age of 54 years were included in this study. The mean preoperative GS was 10.0 with a modified GS of 23.3. The mean postoperative GS was 4.0 (P = 0.001) with a modified GS of 10.67 (P = 0.001). There were no complications related to the surgery itself in any of the reported cases.ConclusionsBrainPath EAMD evacuation of severe IVH secondary to sICH appears to be a safe and effective treatment modality that significantly increases the extent of IVH clearance, which could also lead to improved long-term patient outcomes.Copyright © 2019 Elsevier Inc. All rights reserved.

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