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Neurology India 2021Endoscopic third ventriculostomy (ETV) has become a proven modality for treating obstructive and selected cases of communicating hydrocephalus. (Review)
Review
BACKGROUND
Endoscopic third ventriculostomy (ETV) has become a proven modality for treating obstructive and selected cases of communicating hydrocephalus.
OBJECTIVE
This review aims to summarize the indications, preoperative workup, surgical technique, results, postoperative care, complications, advantages, and limitations of an ETV.
MATERIALS AND METHODS
A thorough review of PubMed and Google Scholar was performed. This review is based on the relevant articles and authors' experience.
RESULTS
ETV is indicated in obstructive hydrocephalus and selected cases of communicating hydrocephalus. Studying preoperative imaging is critical, and a detailed assessment of interthalamic adhesions, the thickness of floor, arteries or membranes below the third ventricle floor, and prepontine cistern width is essential. Blunt perforation in a thin floor, while bipolar cautery at low settings and water jet dissection are preferred in a thick floor. The appearance of stoma pulsations and intraoperative ventriculostomography reassure stoma and basal cistern patency. The intraoperative decision for shunt, external ventricular drainage, or Ommaya reservoir can be taken. Magnetic resonance ventriculography and cine phase-contrast magnetic resonance imaging can determine stoma patency. Good postoperative care with repeated cerebrospinal fluid drainage enhances outcomes in selected cases. Though the complications mostly occur in an early postoperative phase, delayed lethal ones may happen. Watching live surgeries, assisting expert surgeons, and practicing on cadavers and models can shorten the learning curve.
CONCLUSION
ETV is an excellent technique for managing obstructive and selected cases of communicating hydrocephalus. Good case selection, methodical technique, and proper training under experts are vital.
Topics: Cerebral Ventricles; Humans; Hydrocephalus; Magnetic Resonance Imaging; Third Ventricle; Ventriculostomy
PubMed: 35103009
DOI: 10.4103/0028-3886.332253 -
British Medical Journal Feb 1970
Topics: Cerebral Ventriculography; Humans; Pneumoencephalography
PubMed: 5309321
DOI: 10.1136/bmj.1.5694.502 -
AJNR. American Journal of Neuroradiology Apr 2020The cerebral ventricles have been studied since the fourth century BC and were originally thought to harbor the soul and higher executive functions. During the infancy... (Review)
Review
The cerebral ventricles have been studied since the fourth century BC and were originally thought to harbor the soul and higher executive functions. During the infancy of neuroradiology, alterations to the ventricular shape and position on pneumoencephalography and ventriculography were signs of mass effect or volume loss. However, in the current era of high-resolution cross-sectional imaging, variation in ventricular anatomy is more easily detectable and its clinical significance is still being investigated. Interpreting radiologists must be aware of anatomic variations of the ventricular system to prevent mistaking normal variants for pathology. We will review of the anatomy and development of the lateral ventricles and discuss several ventricular variations.
Topics: Humans; Lateral Ventricles
PubMed: 32079598
DOI: 10.3174/ajnr.A6456 -
Current Journal of Neurology Jul 2020This publication reviews the steps in the path towards obtaining a complete image of the brain. Up to the 1920s, plain X-ray films could demonstrate only calcified... (Review)
Review
This publication reviews the steps in the path towards obtaining a complete image of the brain. Up to the 1920s, plain X-ray films could demonstrate only calcified tumors, shifts in midline position of a calcified pineal gland due to a mass in the cranium, or foreign metallic objects within the skull. Walter Dandy reported in 1918 that he visualized cerebral ventricles by introducing air as a contrast agent through a trocar into one of the occipital lobes or the right frontal horn of the ventricular system. Dandy localized lesions that distorted or shifted the ventricles. In 1920, Dandy placed air by lumbar puncture into the spinal subarachnoid space that could visualize the brain and entire ventricles. Antonio Egas Moniz with the assistance of his neurosurgeon colleague, Almeida Lima, obtained X-ray images of cerebral arteries of dogs and decapitated human heads from corpses after injecting strontium bromide into their carotid arteries. Satisfied by these experiments, Moniz injected strontium bromide directly into carotid arteries of five patients which failed to show intracranial vessels. In the sixth patient, intracranial arteries were outlined but that patient died of cerebral thrombosis presumably due to the hyper-osmolality of that contrast agent. Finally, on June 18, 1927, Moniz injected 22% sodium iodine into a 20-year-old man and obtained clear visualization of his carotid artery and intracerebral branches after temporarily occluding the artery with a ligature. Direct percutaneous puncture of the cervical carotid artery remained the primary technique unto the 1960s to visualize intracranial blood vessels until Seldinger's technique was introduced in 1953. Computerized axial tomography (CAT) and magnetic resonance imaging (MRI) replaced cerebral arteriography for localizing tumors and epidural or subdural hemorrhage. However, angiography is used currently for embolization of aneurysms and removal of thrombi or emboli in patients with acute stroke.
PubMed: 38011427
DOI: 10.18502/cjn.v19i3.5426 -
Journal of Neurology, Neurosurgery, and... Oct 1965
Topics: Cerebellar Diseases; Cerebral Angiography; Cerebral Hemorrhage; Cerebral Ventriculography; Hematoma; Humans; Hypertension; Male; Middle Aged; Vertebral Artery
PubMed: 5294512
DOI: 10.1136/jnnp.28.5.442 -
Journal of Neurology, Neurosurgery, and... May 1983In order to determine if the neurologic manifestations in chronic hyponatraemia result partly from brain oedema, we measured the cerebral ventricular volume before and... (Review)
Review
In order to determine if the neurologic manifestations in chronic hyponatraemia result partly from brain oedema, we measured the cerebral ventricular volume before and after correction of hyponatraemia in eight patients with central nervous system manifestations. Only the three patients with seizures showed a clear change in the ventricular size and probably had brain oedema.
Topics: Adult; Aged; Brain Edema; Cerebral Ventricles; Cerebral Ventriculography; Chronic Disease; Female; Humans; Hyponatremia; Male; Middle Aged; Tomography, X-Ray Computed
PubMed: 6101182
DOI: 10.1136/jnnp.46.5.443 -
AJNR. American Journal of Neuroradiology Sep 1994To present the CT and MR findings in children with propionic and methylmalonic acidemia. (Review)
Review
PURPOSE
To present the CT and MR findings in children with propionic and methylmalonic acidemia.
METHODS
Twenty-three new patients with methylmalonic and 20 with propionic acidemia were examined with CT and/or MR of the brain. In total 52 CT and 55 MR studies were done. Twenty-six previously published cases were also reviewed.
RESULTS
The findings were similar in the two syndromes. During the first month of life the examinations were either normal or showed white matter attenuation. Later during the first year moderate or even severe widening of sulci and fissures was seen, especially in infants with propionic acidemia. During therapy, these changes often resolved, especially in the patients with methylmalonic acidemia. Mild to moderate delay in myelination was also a common finding in both disorders. Basal ganglia changes, predominately in the globus pallidus, were seen in five patients with methylmalonic acidemia and in two children with propionic acidemia; in two patients these changes were transient.
CONCLUSION
Children who have methylmalonic or propionic acidemia, in addition to widening of cerebrospinal fluid spaces and some delay in myelination, also often show symmetric involvement of the basal ganglia.
Topics: Amino Acid Metabolism, Inborn Errors; Basal Ganglia; Brain; Cerebral Ventricles; Cerebral Ventriculography; Child; Child, Preschool; Female; Globus Pallidus; Humans; Infant; Infant, Newborn; Magnetic Resonance Imaging; Male; Methylmalonic Acid; Myelin Sheath; Propionates; Tomography, X-Ray Computed
PubMed: 7985563
DOI: No ID Found -
Journal of Neurology, Neurosurgery, and... May 1984A ventricular diverticulum was found on computed tomography in six out of 25 cases of congenital obstructive hydrocephalus. In all six cases, the diverticulum was...
A ventricular diverticulum was found on computed tomography in six out of 25 cases of congenital obstructive hydrocephalus. In all six cases, the diverticulum was located on the medial wall of the trigone. In three cases, it was restricted to the tentorial hiatus with a recognisable superior cerebellar cistern (small). In two cases, it occupied the tentorial hiatus without a recognisable cistern (medium). The remaining case had a diverticulum extending into the posterior fossa that caused cerebellar ataxia (large). In all patients, the diverticulum regressed after ventriculo-peritoneal shunt. The characteristics of the computed tomograms, the clinical significance and the pathogenesis of this phenomenon are discussed.
Topics: Brain Diseases; Cerebral Ventricles; Cerebral Ventriculography; Child; Diverticulum; Female; Humans; Hydrocephalus; Infant; Infant, Newborn; Male; Tomography, X-Ray Computed
PubMed: 6429284
DOI: 10.1136/jnnp.47.5.514