Abstract:
BACKGROUND:Entrapped fourth ventricle is the result of both inlet aqueduct and outlet fourth ventricular midline and lateral foraminae obstruction. It occurs as a sequalae of intracranial hemorrhagic or inflammatory disease condition. Usually it presents after previous shunting for communicating hydrocephalus with a period of improvement, after which manifestations of posterior fossa expanding process appear. The diagnosis of this rare condition is easy considering the patient past history and the recent clinical state, together with the midline CSF density of the dilated fourth ventricle in either the CT or MR images. The treatment options for this condition include open and endoscopic approaches together with the traditional ventricular to extracranial CSF diversionary procedures. OBJECTIVE:The aim of the study was to adopt a procedure for treatment of entrapped fourth ventricle that carries the advantage of the minimally invasive technique thus avoiding the complications of the traditional opened and shunt surgeries as well as decreasing multiple procedures due to aqueduct restenosis or stent fall. METHODS:Thirteen patients with symptomatic entrapped fourth ventricle underwent suboccipital endoscopic trans-fourth ventricular aqueductoplasty from May 2007 till November 2011. The Gabb endoscopic system was used and aqueductoplasty was performed using 3F Fogarty balloon followed by stent placement. Nine patients were females. The mean age was 3.6 years and the mean follow up period was 23 months. All cases had a previous one or two supratentorial VP shunt placement. RESULTS:Short stent was used in eight patients. During the follow up, stent migration occurred in five of them. Three of these five patients developed posterior fossa compression manifestations due to aqueduct restenosis. Long stent from the aqueduct till the bur hole site for these three patients and the following five patients was used. All cases showed both clinical and radiologic improvement. Apart from the stent migration, no procedure-related complications were encountered. CONCLUSION:Endoscopic suboccipital paramedian aqueductoplasty with the use of a stent is a safe and effective surgical option that-in our opinion-should stand as the first line treatment for the entrapped fourth ventricle. Long stent is better used after aqueductoplasty to avoid the restenosis if no stent is used or stent fall after short stents. However, good case selection, familiarity with this fairly common endoscopic approach and longer follow-up is needed for obtaining an optimal result.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Raouf A,Zidan Idoi
10.1007/s00701-013-1843-5subject
Has Abstractpub_date
2013-10-01 00:00:00pages
1957-63issue
10eissn
0001-6268issn
0942-0940journal_volume
155pub_type
杂志文章abstract::An experimental technique for producing delayed cerebral vasospasm in a rabbit model is described. The basilar artery is punctured via the transclival route and angiographic verification is illustrated. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01406370
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Operative skills are key to neurosurgical resident training. They should be acquired in a structured manner and preferably starting early in residency. The aim of this study was to test the hypothesis that the outcome and complication rate of anterior cervical discectomy and fusion with or without instrument...
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pub_type: 杂志文章,评审
doi:10.1007/s00701-007-1179-0
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doi:10.1007/s00701-002-1043-1
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pub_type: 杂志文章
doi:10.1007/s00701-017-3277-y
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pub_type: 杂志文章
doi:10.1007/s00701-010-0675-9
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1007/s00701-012-1580-1
更新日期:2013-03-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-007-1061-5
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abstract::In theory, lymphokine-activated killer (LAK) cells offer a potential method to treat cerebral gliomas, especially low-grade gliomas. LAK cells would be administered by repeated injections straight into the cavity of a subtotally removed tumour. However, brain-tumour cyst fluid has been shown to be immunosuppressive in...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01400532
更新日期:1988-01-01 00:00:00
abstract::At the National Institute of Neurosurgery a team of ophthalmologists and neurosurgeons has for 20 years been collaborating in the research and treatment of optic nerve gliomas. Among 34 patients, 30 were under the age of 20 years, and 20 under the age of 10 years. Of the 20 patients younger than 10 years, 16 were girl...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01809149
更新日期:1978-01-01 00:00:00
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doi:10.1007/s00701-011-1080-8
更新日期:2011-10-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01401468
更新日期:1994-01-01 00:00:00
abstract::The patient is a 44-year-old man who underwent resection of a posterior nasopharynx tumor 12 years earlier via left lateral rhinotomy approach. The final pathological analysis indicated the tumor was a craniopharyngioma, and the patient subsequently underwent focal radiation. The patient returned to medical attention ...
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pub_type: 杂志文章
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更新日期:1996-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s00701-014-2160-3
更新日期:2014-09-01 00:00:00
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pub_type: 杂志文章
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更新日期:2009-05-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-017-3187-z
更新日期:2017-07-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010100010
更新日期:2001-11-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s00701-004-0279-3
更新日期:2004-07-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 临床试验,杂志文章
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