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Frameless neuronavigation in intracranial endoscopic neurosurgery

Henry W. S. Schroeder, Wolfgang Wagner, Wolfgang Tschiltschke, and Michael R. Gaab

series of 135 patients who underwent an intracranial endoscopic intervention at our institution between May 1996 and October 1999, computerized neuronavigation was used in 44 of them. The mean age of these patients was 31 years (range 1–71 years). There were 29 male and 15 female patients. The diagnoses included noncommunicating hydrocephalus, multiloculated hydrocephalus, arachnoid cysts, intraparenchymal cysts, colloid cysts, intraventricular tumors, isolated fourth ventricles, cavum veli interpositi, and pineal cyst ( Table 1 ). Thirteen third ventriculostomies

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Tuberculoma mimicking a pinealoma

Case report

Ian R. Whittle, John L. Allsop, and Michael Besser

local venous anatomy. In view of the past exposure to TB, the lymphadenopathy, and hypergammaglobulinemia, rifampin (500 mg/day), isoniazid (300 mg/day), and pyridoxine (25 mg/day) were commenced the day after admission. A third ventriculostomy was performed through a right frontal craniotomy 2 days later. Ventricular cerebrospinal fluid (CSF) aspirated during this procedure revealed no white blood cells, 12 red blood cells, and a protein level of 0.58 mg/dl (normal 0.15 to 0.45 mg/dl). In view of the absence of lymphocytes in the CSF, the lesion was considered to be

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Hydrocephalus due to idiopathic stenosis of the foramina of Magendie and Luschka

Report of three cases

Carine Karachi, Caroline Le Guérinel, Pierre Brugières, Eliane Melon, and Philippe Decq

used for the procedure. As shown in Fig. 4 , third ventriculostomy was performed with forceps 13 at the border between the premammillary recess and the tuber cinereum, just behind the prominence of the dorsum sellae. The opening was then immediately controlled by penetrating into the cisterna pontis to identify the dura mater of the clivus and the anterior part of the brainstem and BA. Fig. 4. Intraoperative views obtained during ETV. a: Endoscopic view of the foramen of Monro: fornix (1); choroid plexus (2); anterior septal vein (3); and thalamostriate

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Endoscopic aqueductoplasty through a tailored craniocervical approach

Islam Gawish, Robert Reisch, and Axel Perneczky

procedures: each individual's pathoanatomical configuration plays an important role in the selection of an appropriate endoscopic approach. An unsuitable anatomical situation at the floor of the third ventricle increases the hazards and decreases the success rate of third ventriculostomy. Furthermore, a distally located aqueductal obstruction hinders proper endoscopic exposure through the cranial portion of the aqueduct. The well-known long-term complications of the shunt system 2, 10, 25, 33 and the superiority of endoscopic management in the treatment of obstructive

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Neurofiberscope-guided management of slit-ventricle syndrome due to shunt placement

Mikhail F. Chernov, Shuji Kamikawa, Fumitaka Yamane, Shoichiro Ishihara, and Tomokatsu Hori

-called “complete third ventriculostomy” was performed. After endoscopic inspection of the basal subarachnoid cisterns the shunt device was removed completely. It should be noted that in all four patients either obstruction or stenosis of the sylvian aqueduct was identified endoscopically during surgery. Fig. 3. Intraoperative photographs showing the steps of ETV. Note the thinned floor of the third ventricle between the infundibular recess and mammillary bodies (left) , the insertion of the No. 4 French Fogarty balloon catheter in the middistance between infundibular

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Purely cystic form of choroid plexus papilloma with acute hydrocephalus in an infant

Case report

Yasushi Miyagi, Yoshihiro Natori, Satoshi O. Suzuki, Toru Iwaki, Takato Morioka, Koichi Arimura, Yoshihisa Maeda, Tadahisa Shono, Koichiro Matsukado, and Tomio Sasaki

pulsatile CSF movement in the third ventricle. Operation On the basis of a diagnosis of aqueductal obstruction, third ventricle tumor, and acute hydrocephalus, emergency surgery was undertaken with the intention of removing the cystic lesion in the third ventricle and/or performing a third ventriculostomy. General anesthesia was induced, and a bur hole was placed in the right frontal region. After puncture of the anterior horn of the lateral ventricle, an endoscope was inserted through a No. 16 French sheath. A cyst was found attached by means of a small pedicle

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Efficacy of neuroendoscopic procedures in minimally invasive preferential management of pineal region tumors: a prospective study

Shizuo Oi, Masayoshi Shibata, Jiro Tominaga, Yumie Honda, Masaki Shinoda, Futoshi Takei, Ryuichi Tsugane, Kazuhito Matsuzawa, and Osamu Sato

WNRT. An EVD system was used for postoperative management in all patients with ventriculomegaly who had undergone third ventriculostomy or craniotomy. A daily CSF specimen was obtained for cytological analysis. The EVD system was kept open even in patients in whom there was no intraoperative evidence of tumor dissemination. After confirmation of cytological findings negative for tumor tissue in CSF for several days after the procedure, continuous ICP monitoring was performed to check the patency of the third ventriculostomy or the reopened aqueduct. If the CSF

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Failure of a Torkildsen shunt after functioning for 50 years

Case report

Pascal O. Zinn, Oliver Bozinov, Jan-Karl Burkhardt, Robert Reisch, M. Gazi Yaşargil, and Helmut Bertalanffy

of the distension. Discussion Idiopathic or true aqueductal stenosis, such as congenital narrowing of the aqueduct, occurs in only 4–8% of infants with obstruction of the aqueduct. 9 Walter Dandy first introduced the idea of third ventriculostomy; 2 , 8 later the technique was improved by Stookey and Scarff. 10 Their method was to approach the lamina terminalis by means of a subfrontal or subtemporal route through the interpeduncular cistern into the floor of the third ventricle. 7 , 13 It was Torkildsen 12 who invented the ventriculocisternostomy. In

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Neuroendoscopic findings in patients with intracranial germinomas correlating with diabetes insipidus

John C. Wellons III, Alyssa T. Reddy, R. Shane Tubbs, Hussein Abdullatif, W. Jerry Oakes, Jeffrey P. Blount, and Paul A. Grabb

Nishio S, Inamura T, Takeshita I, et al: Germ cell tumor in the hypothalamo-neurohypophysial region: clinical features and treatment. Neurosurg Rev 16: 221–227, 1993 10.1007/BF00304332 40. Pople IK , Athanasiou TC , Sandeman DR , et al : The role of endoscopic biopsy and third ventriculostomy in the management of pineal region tumours. Br J Neurosurg 15 : 305 – 311 , 2001 Pople IK, Athanasiou TC, Sandeman DR, et al: The role of endoscopic biopsy and third ventriculostomy in the management of pineal region tumours. Br J

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A new method of ultrasonic guidance of neuroendoscopic procedures

Technical note

Martin Strowitzki, Michael Kiefer, and Wolf-Ingo Steudel

56, F intraventricular tumor tumor resection 8 56, F colloid cyst evacuation 9 30, M colloid cyst extirpation 10 65, M aqueductal stenosis third ventriculostomy Illustrative Cases Case 6 A space-occupying cyst developed in a 12-year-old boy after he underwent resection, radiotherapy, and chemotherapy for a malignant rhabdoid tumor located in the right temporoparietal region with isolation of the temporal ventricle ( Fig. 2 upper left ). The endoscope was introduced under ultrasonic guidance, and a