Ultrasound-guided evacuation of spontaneous intracerebral hematoma in the basal ganglia

Real-time ultrasonography was used for the aspiration of intracerebral hematoma in the basal ganglia in 7 patients without signs of impending herniation. The ultrasound device was used to select the trajectory and target point for hematoma drainage. Ultrasound-guided aspiration was performed via a burr hole under local anesthesia. We used a temporal burr hole entry point rather than the more frequently used pre-coronal approach. The burr hole was positioned 4 to 6 cm behind the posterior border of the frontal process of the zygomatic bone and 4 to 5 cm above the external auditory meatus. The hematoma was then evacuated with urokinase irrigation. Ultrasound guidance allows simple, precise localization of the hematoma and the distance from the surface to the target can be calculated. Ultrasound-guided catheter placement for fibrinolysis and hematoma drainage is a simple and safe procedure.