Intracerebral (ICH) and intraventricular (IVH) hemorrhage cause severe morbidity and a high mortality rate. Early surgical evacuation with minimal damage to brain tissue is essential. Endoscopic evacuation using an Endoport system is a promising technique. We present the results of the endoscopic evacuation of ICH and IVH in patients operated from 2010-2019 at the Almenara Hospital in Lima-Peru.

Subarachnoid hemorrhage (SAH) due to rupture of a cerebral aneurysm continues to be a disease with high morbidity and mortality in our setting, despite advances in microsurgery and endovascular therapy. The objective of the present study was to determine the demography, vascular territory, and complications that occur in the perioperative management of patients with ruptured cerebral aneurysms treated at the Cayetano Heredia Hospital.

Multiple aneurysms are responsible for 15 to 35% of spontaneous subarachnoid hemorrhages, some of them being complex aneurysms. Its management is difficult due to the variation in the anatomical distribution and the difficulty of determining which aneurysm is the ruptured one. Embolization has an acceptable complication rate compared to clipping, with the additional benefit of being a minimally invasive technique with a short hospital stay.

Complete resection of a cerebral arteriovenous malformation (AVM) eliminates the risk of bleeding. Although AVMs that adjoin eloquent areas have been studied with functional neuroimaging or intraoperative mapping, the usefulness of tractography has been limited to case reports or small series. Selecting the patient for surgery for an AVM close to an eloquent area is a challenge.

Solitary intracranial plasmacytoma is a rare plasma cell tumor that affects the skull, meninges, and brain. Unlike multiple myeloma, it does not have systemic manifestations. Its symptoms are characterized by a progressively growing tumor that generates local pain. The prognosis is good and the main treatment modalities are surgery and/or radiation therapy

Fluorescein sodium (FNa) is a fluorescent substance used to evaluate cerebral blood flow. Videoangiography with FNa allows examining afferent and efferent vessels during surgery for arteriovenous malformations and evaluating flow during clipping of an aneurysm. We present our first cases of vascular microsurgery using microscope-integrated intraoperative fluorescein videoangiography at Dos de Mayo National Hospital in Perú.