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Technical Reports
Minimally invasive endoscopic evacuation of thalamic hemorrhage by the trans-middle temporal gyrus approach
1 MD, Director, Department of Neurosurgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
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Akira Tempaku
7-5, Inada-chokisen, Obihiro, Hokkaido 080-0833,
Japan
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Article ID: 100021N06AT2025
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Tempaku A. Minimally invasive endoscopic evacuation of thalamic hemorrhage by the trans-middle temporal gyrus approach. Edorium J Neurol 2025;10(1):1–6.ABSTRACT
Aims: Thalamic hemorrhage is known to have a poor clinical prognosis. Although surgical removal of hematoma can contribute to early neurological improvement in other type of intracranial hemorrhage, thalamic hemorrhage is sometimes much more difficult to achieve a good outcome by surgery. Less invasive surgical strategies for thalamic hematoma have been well discussed. However, conventional craniotomy via transinsular approach or endoscopic surgery via the ipsilateral trans-frontal or occipital lobe approach is still more invasive due to the long approach distance.
Methods: The endoscopic trans-middle temporal gyrus approach was used in two cases of thalamic hemorrhage. The navigation system was used to mark the puncture point and to guide toward the hematoma. This helped to spare the eloquent area from surgical invasion.
Results: Thalamic hematoma was evacuated by endoscopic surgery through middle temporal gyrus approach. The less invasive and shorter approach method has contributed to achieve the desired result. It has shown the shorter operation time and reduced amount of bleeding in the operation.
Conclusion: The usefulness of trans-middle temporal gyrus approach for endoscopic-assisted hematoma removal of the thalamic hemorrhage is described here. In addition, the anatomical features and practicalities of this approach are discussed.
Keywords: Endoscope, Middle temporal gyrus, Thalamic hemorrhage
SUPPORTING INFORMATION
Acknowledgments
The author thanks Dr. Ken Kazumata for his useful suggestion and technical advises for this research. Much informative discussion with him contributed to establish this technical protocol.
Author ContributionsAkira Tempaku - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthor declares no conflict of interest.
Copyright© 2025 Akira Tempaku. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
