Stereotaxic reconstruction of the aqueduct of Sylvius.

Abstract:

:A stereotaxic technique has been developed to cannulate the cerebral aqueduct in patients with hydrocephalus resulting from occlusion of the aqueduct of Sylvius. Precise placement of a 15- to 20-mm long radiopaque prosthesis between the third and fourth ventricles can reestablish the normal cerebrospinal fluid (CSF) pathway. Since 1974, seven patients have undergone aqueductal reconstruction. The surgical goal in this series was to manage the hydrocephalus by creating and maintaining a patent aqueductal channel. The follow-up period ranged from 1.5 to 6.5 years. In four cases, aqueductal reconstruction alone resulted in control of the hydrocephalus, although two patients underwent revisions of their prosthesis. Three patients ultimately required shunts, despite initial symptomatic improvement after reconstruction. In these seven cases (13 stereotaxic procedures), no mortality and no significant operative morbidity were encountered. Although the technique is relatively simple to perform, technical difficulties remain. At present, no clinical or radiographic test adequately discerns the ideal candidate for stereotaxic aqueductal reconstruction. Four patients required stereotaxic revision because of malposition or malfunction of the prosthesis. This approach should be reserved for patients with a short aqueductal occlusion, and normal distal CSF pathways and dynamics. The rationale, technique, problems, and results of stereotaxic reconstruction are presented.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Backlund EO,Grepe A,Lunsford D

doi

10.3171/jns.1981.55.5.0800

subject

Has Abstract

pub_date

1981-11-01 00:00:00

pages

800-10

issue

5

eissn

0022-3085

issn

1933-0693

journal_volume

55

pub_type

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