Articles: third-ventricle-surgery.
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Neurofibromatosis type I (NF1) will be associated with hydrocephalus in ≤13% of cases. Currently, very little data are available describing the actual etiologies and treatment options of NF1-associated hydrocephalus. We, therefore, have described our experience in treating NF1-associated hydrocephalus. ⋯ Hydrocephalus in the context of NF1 has been caused mostly by obstructive etiologies. A tailored treatment approach is recommended to address the specific etiology. Regardless of the treatment approach, a relatively high rate of failure has been described.
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Clin Neurol Neurosurg · Aug 2019
The surgical results of endoscopic third ventriculostomy in long-standing overt ventriculomegaly in adults with papilledema.
Longstanding overt vetriculomegaly in adults (LOVA) is a type of chronic hydrocephalus presumed to begin during infancy, which manifests in adults after a long and slow clinical course. Only a quite small number of LOVA case series have been published, controversies regarding optimal management still exist. The authors describe a series of symptomatic LOVA patients with papilledema treated successfully using endoscopic third ventriculostomy (ETV) at a single institution. ⋯ Endoscopic third ventriculostomy provides an effective treatment for LOVA patients with papilledema, which can improve the symptoms of LOVA and relive papilledema. The fundoscopy is of great value in making decisions related to surgical intervention for LOVA patients.
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Endoscopic third ventriculostomy (ETV) is an option for hydrocephalus treatment in patients with myelomeningocele, mostly after a previous shunt dysfunction. Late failure of ETV is a rare event, traditionally associated with dramatic symptoms of intracranial hypertension. In patients with myelodysplasia and neurogenic bladder dysfunction, urodynamic deterioration can be a signal of neurologic worsening as a consequence of tethered cord or shunt problems. ⋯ Pediatric neurosurgeons must follow myelomeningocele patients with successful ETV for a long time and take care of subtle alterations of organic functions that have a close relationship with central nervous system integrity. A multidisciplinary approach can facilitate this strategy and avoid a tragic outcome.
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The cerebellomesencephalic vein (CMV) was frequently sacrificed in surgery approached via the supracerebellar infratentorial (SCIT) route for resecting pineal region tumors, which resulted in potential risk of neurologic deficit. Preserving the CMV in the SCIT approach could enhance the safety and effectiveness of this natural corridor surgery. The aim of this article was to identify the probability and safety of preserving the CMV through the application of neuroendoscopy in the SCIT approach. ⋯ The advantage of close observation and panoramic view provided by neuroendoscopy combined with meticulous manipulation improved the ability to preserve the CMV in resecting pineal region tumors via the SCIT approach. The neuroendoscopic technique enhances the safety and efficacy of the SCIT approach.
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Endoscopic third ventriculostomy (ETV) is now widely used to manage ventriculoperitoneal shunt (VPS) malfunctions, but outcome predictors are still debated. Different opinions exist about the prognostic factors, but shunt duration is generally considered unimportant although its influence remains poorly investigated. ⋯ ETV is the first option for shunt malfunctions in OH and perinatal posthemorrhagic hydrocephalus, regardless of other factors. Conversely, in other types of hydrocephalus, the chances of shunt independence are lower and shunt duration and history of multiple shunt revisions are significant.