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Pathophysiology of persistent syringomyelia after decompressive craniocervical surgery

Clinical article

John D. Heiss, Giancarlo Suffredini, René Smith, Hetty L. DeVroom, Nicholas J. Patronas, John A. Butman, Francine Thomas, and Edward H. Oldfield

compliance, effects that accompanied improved CSF flow. 22 Authors of other studies have reported that patients with hydrocephalus, CM-I, and syringomyelia may benefit from third ventriculostomy. 9 , 11 , 21 , 36 , 38 On the other hand, shunting of CSF from the lumbar intrathecal space can increase tonsillar herniation in patients with CM-I and lead to cerebellar and medullary dysfunction. 57 Because a direct comparison of craniocervical decompression with syrinx shunting was not performed in this study, the superiority of one treatment over the other remains

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Use of percutaneous endoscopy to place syringopleural or cystoperitoneal cerebrospinal fluid shunts

Technical note

James D. Guest, Lisa Silbert, and Carlos E. Casas

decompression of the cyst was confirmed radiologically; however, there was no objective change in his symptoms of sensory loss and motor weakness, and drainage was discontinued. In all cases the intention was to perform the entire procedure endoscopically but this was achieved only in four patients. In two cases of syringomyelia the site of posterior perforation in the spinal cord exhibited a pulsatile billowing appearance very similar to that observed during a third ventriculostomy. Bleeding was minimal and when it occurred it cleared following a few minutes of irrigation

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Disseminated neurenteric cyst

Case report

Muneyoshi Yasuda, Hiroshi Nakagawa, Hiroaki Ozawa, Chikage Inukai, Takeya Watabe, Junichi Mizuno, and Masakazu Takayasu

dissemination and the optimal surgical strategy. Case Report History and Examination The patient was a 46-year-old woman who had presented with nausea and dizziness in 1996. She was treated at a local hospital, where the primary diagnosis was a cyst in the fourth ventricle with hydrocephalus, for which she underwent a suboccipital craniectomy with a cyst fenestration. The pathological diagnosis was a neurenteric cyst. Nausea and dizziness recurred 9 years later, in January 2005, when she was transferred to our institution for an endoscopic third ventriculostomy

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Three-dimensional constructive interference in steady-state magnetic resonance imaging in syringomyelia: advantages over conventional imaging

Florian Roser, Florian H. Ebner, Søren Danz, Felix Riether, Rainer Ritz, Klaus Dietz, Thomas Naegele, and Marcos S. Tatagiba

meningeal cysts . Acta Radiol 45 : 204 – 208 , 2004 22 Klekamp J , Samii M : Syringomyelia: Diagnosis and Treatment Berlin , Springer-Verlag , 2002 23 Laitt RD , Mallucci CL , Jaspan T , McConachie NS , Vloeberghs M , Punt J : Constructive interference in steady-state 3D Fourier-transform MRI in the management of hydrocephalus and third ventriculostomy . Neuroradiology 41 : 117 – 123 , 1999 24 Mallucci CL , Stacey RJ , Miles JB , Williams B : Idiopathic syringomyelia and the importance of occult arachnoid webs, pouches

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Three-dimensional models: an emerging investigational revolution for craniovertebral junction surgery

Atul Goel, Bhavin Jankharia, Abhidha Shah, and Prashant Sathe

investigational modality, at least for complex craniovertebral junction anomalies. References 1 Breimer GE , Bodani V , Looi T , Drake JM : Design and evaluation of a new synthetic brain simulator for endoscopic third ventriculostomy . J Neurosurg Pediatr 15 : 82 – 88 , 2015 10.3171/2014.9.PEDS1447 2 Choi JW , Kim N : Clinical application of three-dimensional printing technology in craniofacial plastic surgery . Arch Plast Surg 42 : 267 – 277 , 2015 10.5999/aps.2015.42.3.267 3 Fujiwara A , Kobayashi N , Saiki K , Kitagawa T

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Direct puncture for diagnosis of intradural spinal arachnoid cyst and fenestration using 3D rotational fluoroscopy: technical note and the “jellyfish sign”

Ziev B. Moses, John H. Chi, and Ram V. S. R. Chavali

thin flexible wire to pierce the cyst followed by balloon inflation parallels that used in endoscopic third ventriculostomy (ETV), in which a semi-blunt dissector is passed through the floor of the third ventricle followed by dilation with a 2- or 3-Fr balloon catheter. 5 It is important to deflate the balloon prior to returning the catheter into the cyst as otherwise it may tear the wall (or the floor of the third ventricle in the case of ETV) and result in bleeding. While in ETV bleeding can be monitored by direct visualization through the endoscope, during