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Bilateral retinal hemorrhage after endoscopic third ventriculostomy: iatrogenic Terson syndrome

Case report

Eelco W. Hoving, Mehrnoush Rahmani, Leonie I. Los, and Victor W. Renardel de Lavalette

E ndoscopic third ventriculostomy is considered to be an effective and safe treatment modality for obstructive hydrocephalus. The success rate of ETV in third ventricle hydrocephalus is reported to be ~ 75–80%. 4 , 6 Various complications related to intracranial endoscopy in general and to ETV in particular have been reported, of which arterial hemorrhages from prepontine cisternal vessels are considered the most serious. 3 , 22 A distinction can be made between perioperative complications and postoperative failure of the ETV. The latter can be further

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Endoscopic third ventriculostomy for VP shunt malfunction during the third trimester of pregnancy: illustrative case

Ahmad K. Alhaj, Tariq Al-Saadi, Marie-Noëlle Hébert-Blouin, Kevin Petrecca, and Roy W. R. Dudley

Endoscopic third ventriculostomy (ETV) is an effective treatment for noncommunicating hydrocephalus. 1–3 As predicted by the ETV Success Score (ETVSS), its effectiveness depends on patient age, the pathology causing hydrocephalus, and whether the patient had a previous ventriculoperitoneal (VP) shunt. Success rates reach 90% in well-selected candidates. 4 ETV has also been found to be a valuable salvage option for VP shunt malfunction, with success rates of 60%–80%. 5–10 In VP shunt–dependent women, the physiological changes of pregnancy may impair shunt

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The role of endoscopic third ventriculostomy in adult patients with hydrocephalus

Clinical article

Michael D. Jenkinson, Caroline Hayhurst, Mohammed Al-Jumaily, Jothy Kandasamy, Simon Clark, and Conor L. Mallucci

E ndoscopic third ventriculostomy has rapidly gained acceptance as the treatment of choice for hydrocephalus in children. 6 , 7 , 16 , 21 , 24 The success of ETV is dependant primarily on the causes of the hydrocephalus 17 and is ideally suited to obstructive causes such as tumors 11 , 16 , 20 , 24 and aqueduct stenosis. 17 , 23 Endoscopic third ventriculostomy has traditionally been the preserve of pediatric neurosurgeons, and the authors of most studies in the literature report either exclusively pediatric cohorts 6 , 7 , 24 or mixed groups of

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Endoscopic third ventriculostomy and biopsy of a tectal lesion using flexible neuroendoscopy and urological cup forceps: illustrative case

Meredith Yang, Daniel Wolfson, Melissa A. LoPresti, Emma Poland, Sandi Lam, and Michael DeCuypere

influence decision making. Thus, treatment goals for symptomatic tumors are twofold: CSF diversion and tissue diagnosis. Methods of sampling pineal region tumors include open biopsy or, more recently, endoscopic biopsy. 2 First described in 1997 while using a flexible neuroendoscope, 3 simultaneous endoscopic third ventriculostomy (ETV) and biopsy through a single burr hole has been demonstrated to be safe and diagnostically efficacious, allowing surgeons to procure tissue and treat hydrocephalus in one procedure. Herein, we describe our experience with single burr

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Is the distance between mammillary bodies predictive of a thickened third ventricle floor?

Clinical article

Corrado Iaccarino, Enrico Tedeschi, Armando Rapanà, Ilario Massarelli, Giuseppe Belfiore, Mario Quarantelli, and Alfredo Bellotti

) of tuber cinereum region before perforation. Two patients with acute hydrocephalus (Cases 22 and 23; Table 1 ) were eliminated from subsequent analysis due to inadequate assessment of the MBs either on endoscopic viewing (Case 22, leptomeningeal carcinomatosis with multiple metastatic nodules occupying the area of the tuber cinereum) or on both the ETV and preoperative MR imaging (Case 23, large suprasellar arachnoid cyst). In the latter case, however, TVF fenestration could be performed uneventfully. Endoscopic third ventriculostomy procedures were rated as

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Negative-pressure hydrocephalus in the course of a complex postoperative intracranial pressure disturbance: illustrative case

Tomoya Suzuki, Shogo Kaku, Kostadin Karagiozov, and Yuichi Murayama

others. 1–4 Negative-pressure external ventricular drainage (EVD), 1 , 3 endoscopic third ventriculostomy (ETV), 5 , 6 neck wrapping (or a cervical tourniquet), 1 , 7 intermittent shunt valve pressing, and enforced recumbency were applied to treat patients with poor outcomes. 4 , 7–9 This report describes an adult patient with iatrogenic NePH whose management was successful and whose symptoms disappeared without requiring permanent cerebrospinal fluid (CSF) diversion. Illustrative Case Clinical Course Before Surgery A 48-year-old man with a vertebral artery (VA

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Shunt freedom in slit ventricle syndrome: using paradoxical ventriculomegaly following lumbar shunting to our advantage. Illustrative cases

Kevin Gilbert, Jillian H. Plonsker, Jessica Barnett, Omar Al Jammal, Arvin R. Wali, Mihir Gupta, and David Gonda

, although the condition may be acquired at any age after any amount of time. 3 There is a lack of consensus regarding optimal treatment of shunt failure in SVS. Placement of a ventricular catheter may require image guidance due to small ventricular chambers, while endoscopic third ventriculostomy (ETV) is challenging due to the narrow working ventricular corridor. According to a 2017 survey of pediatric neurosurgeons, the most commonly preferred treatments of SVS include ventriculoperitoneal (VP) shunting, cranial expansion, antisiphon device placement, and ETV. 4

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Mesencephalic developmental venous anomaly causing obstructive hydrocephalus: illustrative case

Kota Hiraga, Shigemasa Hayashi, Ryosuke Oshima, Tatsuma Kondo, Fumiaki Kanamori, and Ryuta Saito

axial T1-weighted MR image showing that the bilateral temporal horns and third ventricle are dilated. The Evans index is 0.44. B: Preoperative sagittal T1-weighted contrast-enhanced MR image. The DVA directly above the cerebral aqueduct is observed as the abnormal distended linear region with enhancement ( yellow arrow ). The fourth ventricle is not dilated. An enhancing structure within the frontal horn is aliasing. C: Preoperative digital subtraction angiography shows a mesencephalic DVA ( red arrow ). The patient underwent endoscopic third ventriculostomy

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Conservative management of intraventricular migration of a gelatin sponge: illustrative case

Katherine G. Holste, Bridger Rodoni, Arushi Tripathy, Jaes C. Jones, Sara Saleh, and Hugh J. L. Garton

differentiating it from a clot was fairly straightforward. There have been a few prior reports of intraventricular migration of Gelfoam, although in these cases, CSF obstruction was observed, and retrieval of the Gelfoam was performed. One case of a 12-year-old girl who underwent an endoscopic third ventriculostomy (ETV) sustained intraventricular Gelfoam migration and subsequent obstruction of her ETV. 10 In another case, a piece of Gelfoam was found to be obstructing the cerebral aqueduct causing triventricular ventriculomegaly 3 months after endoscopic cyst fenestration

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Ruptured intraventricular brain abscesses due to Fusobacterium nucleatum with obstructive hydrocephalus: illustrative case

Nina Srour, Audrey Demand, Yi Zhang, William Musick, Annette Lista, and Jiejian Lin

. CSF cytology was negative for a malignant process and CSF pathology only confirmed suppurative diagnosis. The patient was transferred to the Houston Methodist main hospital neurosurgical ICU for higher level of care. Antimicrobial coverage was broadened to linezolid, meropenem, and intrathecal vancomycin and gentamicin. Repeat head CT revealed progressive pus in the left lateral ventricle with obstructive hydrocephalus, necessitating endoscopic third ventriculostomy and placement of a second right frontal EVD. The patient’s neurological symptoms gradually improved