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Keyhole to the brain: Walter Dandy and neuroendoscopy

Historical vignette

Wesley Hsu, Khan W. Li, Markus Bookland, and George I. Jallo

T he field of neuroendoscopy accompanies virtually the entirety of modern neurosurgical history, although its impact on neurosurgery has only recently begun to match the magnitude of its past. During the 1910s and 1920s, neuroendoscopy was one of many technological advances in the field of neurosurgery. Harvey Cushing introduced the first vascular clip, 19 Dandy 10 performed the first pneumoventriculography, and Weed and McKibben 28 described the use of hypertonic solutions to reduce intracranial pressure. It is easy to imagine how amid all of these

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Electromagnetic-guided neuroendoscopy in the pediatric population

Clinical article

Meharpal Sangra, Simon Clark, Caroline Hayhurst, and Conor Mallucci

A dvances in neuroendoscopy have led to an increase in its range of uses in the treatment of a variety of neurosurgical conditions. 7 This is especially true in pediatric neurosurgery where its role in the treatment of conditions such as obstructive and multiloculated hydrocephalus, arachnoid cysts, and tumor biopsy have become established. In an attempt to reduce morbidity associated with these procedures and improve outcome, endoscopy is now being used with image-guided neuronavigation. 9 , 22 , 27 The options available have included frame-based as

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Neuroendoscopy: past, present, and future

Khan W. Li, Clarke Nelson, Ian Suk, and George I. Jallo

Neuroendoscopy began with a desire to visualize the ventricles and deeper structures of the brain. Unfortunately, the technology available to early neuroendoscopists was not sufficient in most cases for these purposes. The unique perspective that neuroendoscopy offered was not fully realized until key technological advances made reliable and accurate visualization of the brain and ventricles possible. After this technology was incorporated into the device, neuro-endoscopic procedures were rediscovered by neurosurgeons. Endoscopic third ventriculostomy and other related procedures are now commonly used to treat a wide array of neurosurgically managed conditions. A seemingly limitless number of neurosurgical applications await the endoscope. In the future, endoscopy is expected to become routine in modern neurosurgical practice and training.

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Comparison of two algorithms for the application of real-time image mosaicking in neuroendoscopy

Laboratory investigation

Kay Niklas Liebig, Homajoun Maslehaty, Athanasios K. Petridis, Wolfgang Konen, and Martin Scholz

D ue to technological progress, neuroendoscopy has become an important tool in our therapeutic armamentarium, and the field of application has broadened. 2 , 7 , 9 , 10 , 19 , 24 , 25 , 27 , 29 Although neuroendoscopy enables illumination and inspection in different areas of interest without traumatizing brain structures, the field of view is restricted. In the present study we intended to improve this restricted field by developing a model to obtain a panoramic view of the lateral ventricle and to increase orientation and safety during neuroendoscopic

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Intraventricular bone dust migration after neuroendoscopy: report of 2 cases

Tarek Y. El Ahmadieh, Cody B. Wolfe, Joyce Koueik, Bradley E. Weprin, Bermans J. Iskandar, and Angela V. Price

pellucidum was fenestrated to allow visualization of the contralateral ventricle and interventricular foramen, both of which appeared normal. The skin was closed over the burr hole site. A head CT scan obtained on postoperative day 1 showed interval decrease of the size of the right ventricle with near resolution of the calcifications along the tract ( Fig. 3C ). The patient had no postoperative complications and had stable imaging findings 3 years postoperatively ( Fig. 3D ). Discussion Neuroendoscopy has demonstrated safety and efficacy in the treatment of a host of

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Application of a 980-nanometer diode laser in neuroendoscopy: a case series

Rodolfo Casimiro Reis, Manoel Jacobsen Teixeira, Marilia Wellichan Mancini, Luciana Almeida-Lopes, Matheus Fernandes de Oliveira, and Fernando Campos Gomes Pinto

V entricular neuroendoscopy represents an important advance in the treatment of hydrocephalus. About 30% of patients with hydrocephalus meet the criteria for this technique, which may prevent the need for a ventriculoperitoneal shunt, resulting in reduced costs and low incidence of late complications. 4 , 5 , 6 , 7 , 12 , 15 , 17 Nonetheless, because a ventricular endoscope is used through a single bur hole, additional resources to enable cutting, coagulation, and ablation of injuries are extremely relevant to reduce surgical time and hospital length 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

hole flexible neuroendoscopy for ETV and biopsy and showcase a novel reappropriation of urological biopsy forceps to complement a flexible neuroendoscopic approach. Illustrative Case A healthy 13-year-old male presented with morning headaches and emesis for 4 weeks. Brain computed tomography demonstrated triventricular enlargement with transependymal flow. Magnetic resonance imaging revealed a contrast-enhancing cystic lesion of the tectal region, compressing and occluding the cerebral aqueduct and resulting in obstructive hydrocephalus ( Fig. 1 ). FIG. 1

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Flexible neuroendoscopy for endoscopic third ventriculostomy and fourth ventricular arachnoid cyst fenestration in an infant

Luis Fernandez, Melissa A. LoPresti, Jae Eun Lee, Michael DeCuypere, and Sandi K. Lam

treatment using a flexible endoscope. 4 We present, to our knowledge, the first report of a single frontal burr hole being used for flexible neuroendoscopy to provide initial treatment of obstructive hydrocephalus and a fourth ventricular arachnoid cyst in a pediatric patient. We include an annotated intraoperative video ( Video 1 ) describing our technique, a review of the literature via a single database search exploring treatment of all reported fourth ventricular arachnoid cysts, and discussion of special considerations when using this approach, to help instruct and

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Piezosurgery-, neuroendoscopy-, and neuronavigation-assisted intracranial approach for removal of a recurrent petrous apex cholesteatoma: technical note

Juergen Grauvogel, Christian Scheiwe, Waseem Masalha, Tanja Grauvogel, Jan Kaminsky, and Ioannis Vasilikos

postoperative care and maintenance; this procedure therefore does not limit patients in their future activities, which might be of particular importance in younger and pediatric populations. 30 In the CWD procedure, the posterior semicircular canal is removed, resulting in improved visualization of the disease and the affected middle ear anatomy. 30 This technical note describes an alternative method for removal of a recurrent petrous apex cholesteatoma in a 14-year-old girl via a retrosigmoid approach using the techniques of piezoelectric surgery, neuroendoscopy, and

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Rigid versus flexible neuroendoscopy: a systematic review and meta-analysis of endoscopic third ventriculostomy for the management of pediatric hydrocephalus

Daphne Li, Vijay M. Ravindra, and Sandi K. Lam

A dvances in neuroendoscope technology have changed the ability to visualize and navigate the ventricular system. Consequently, these tools have helped to expand our realm of surgical techniques in the treatment of pathologies such as hydrocephalus. Rigid neuroendoscopy has been in use since the early 1900s, by L’Espinasse and Dandy, whereas flexible neuroendoscopy was not introduced until the 1970s by Fukushima. 1 Both of these modalities have been used in performing endoscopic third ventriculostomy (ETV) with or without choroid plexus cauterization