Endoscopic Tracking of a Ventricular Catheter for Entry into the Lateral Ventricle: Technical Note

The aim in reporting this case was to discuss the pathophysiology and treatment issues in an infant with a giant syringobulbia associated with a right cerebellopontine angle (CPA) arachnoid cyst causing noncommunicating hydrocephalus. This 7-month-old infant presented to the hospital with a history of delayed milestones and an abnormal increase in head circumference. Magnetic resonance images and CT scans of the brain showed a large CSF cavity involving the entire brainstem and a right CPA arachnoid cyst causing obstruction of the fourth ventricle and dilation of the lateral and third ventricles. Cerebrospinal fluid diversion was performed by direct communication from the syringobulbia cavity to the left lateral ventricle and from the left lateral ventricle through another ventricular catheter; external ventricular drainage was performed temporarily for 5 days. Communication between the syrinx and arachnoid cyst was confirmed. Clinically, there was a reduction in head circumference, and serial MR imaging of the brain showed a decrease in the size of the syrinx cavity and the ventricle along with opening of the normal CSF pathways. The postoperative course was uneventful, and no further intervention was necessary. On follow-up of the child at 3 years, his developmental milestones were normal. Surgical intervention for this condition is mandatory. The appropriate type of surgery should be performed on the basis of the pathophysiology of the developing syringobulbia.

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Combined Endoscopically Guided Third Ventriculostomy with Prepontine Cistern Placement of the Ventricular Catheter in a Ventriculo-Peritoneal Shunt: Technical Note

min - Minimally Invasive Neurosurgery ◽

10.1055/s-2007-985374 ◽

2007 ◽

Vol 50 (4) ◽

pp. 247-250 ◽

Cited By ~ 5

Author(s):

H. Stan ◽

C. Popa ◽

A. Iosif ◽

S. Nistor

Keyword(s):

Technical Note ◽

Third Ventriculostomy ◽

Ventricular Catheter ◽

Prepontine Cistern ◽

Ventriculo Peritoneal Shunt

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Ventricular catheter tack-down suture: Technical note

Surgical Neurology ◽

10.1016/j.surneu.2004.12.024 ◽

2005 ◽

Vol 64 (3) ◽

pp. 270-271

Author(s):

Eric C. Leuthardt ◽

Michael R. Chicoine ◽

Robert L. Grubb

Keyword(s):

Technical Note ◽

Ventricular Catheter

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Intraventricular entrapment of shunt catheter causing shunt malfunction

Romanian Neurosurgery ◽

10.1515/romneu-2015-0048 ◽

2015 ◽

Vol 29 (3) ◽

pp. 357-360

Author(s):

Amit Agrawal ◽

Reddy V. Umamaheswara ◽

Yashwant Sandeep

Keyword(s):

Clinical Outcome ◽

Lateral Ventricle ◽

Female Child ◽

Shunt Malfunction ◽

Ventricular Catheter ◽

Good Clinical Outcome ◽

Shunt Catheter ◽

Ventricular Catheters ◽

Intraventricular Septations

Abstract Intraventricular septations can lead to compartmentalization of the ventricles that can result in “complex or loculated hydrocephalus”. We report a case of 7 year old female child who underwent multiple shunt revisions where there was intraventricular entrapment of shunt catheter leading to obstruction of the shunt and malfunction. In present case we placed the ventricular catheter in contra-lateral ventricle with good clinical outcome. With the recent advancements endoscopic guided removal of the old malfunctioning ventricular catheters is considered the safest option.

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The relative efficacy of 3 different freehand frontal ventriculostomy trajectories: a prospective neuronavigation-assisted simulation study

Journal of Neurosurgery ◽

10.3171/2016.1.jns152263 ◽

2017 ◽

Vol 126 (1) ◽

pp. 304-311 ◽

Cited By ~ 2

Author(s):

Matthew A. Kirkman ◽

William Muirhead ◽

Nick Sevdalis

Keyword(s):

Lateral Ventricle ◽

External Auditory Meatus ◽

Ventricular Catheter ◽

Anatomical Landmarks ◽

Medial Canthus ◽

Foramen Of Monro ◽

Prospective Data ◽

Neurosurgical Procedure ◽

Catheter Tip ◽

Imaging Performance

OBJECTIVE Ventriculostomy is a relatively common neurosurgical procedure, often performed in the setting of acute hydrocephalus. Accurate positioning of the catheter is vital to minimize morbidity and mortality, and several anatomical landmarks are currently used. The aim of this study was to prospectively evaluate the relative performance of 3 recognized trajectories for frontal ventriculostomy using imaging-derived metrics: perpendicular to skull (PTS), contralateral medial canthus/external auditory meatus (CMC/EAM), and ipsilateral medial canthus/external auditory meatus (IMC/EAM). METHODS Participants completed 9 simulated ventriculostomy attempts (3 of each trajectory) on a model head with Medtronic StealthStation coregistered imaging. Performance measures were distance of the ventricular catheter tip to the foramen of Monro (FoM) and presence of the catheter tip in a lateral ventricle. RESULTS Thirty-one individuals of varying seniority and prior ventriculostomy experience performed a total of 279 simulated freehand frontal ventriculostomies. The PTS and CMC/EAM trajectories were found to be significantly more likely to result in both the catheter tip being closer to the FoM and in a lateral ventricle compared with the IMC/EAM trajectory. These findings were not influenced by the prior ventriculostomy experience of the participant, corroborating the significance of these results. CONCLUSIONS The PTS and CMC/EAM trajectories were superior to the IMC/EAM trajectories during freehand frontal ventriculostomy in this study, and further data from studies incorporating varying ventricular sizes and bur hole locations are required to facilitate a change in clinical practice. In addition, neuronavigation and other guidance techniques for ventriculostomy are becoming increasingly popular and may be superior to freehand techniques, necessitating further prospective data evaluating their safety, efficacy, and feasibility for routine clinical use.

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Aventricular hemispherotomy: technical note

Journal of Neurosurgery Pediatrics ◽

10.3171/2020.5.peds20247 ◽

2020 ◽

Vol 26 (6) ◽

pp. 642-647

Author(s):

Cameron Brimley ◽

Vivek P. Buch ◽

Jared M. Pisapia ◽

Benjamin C. Kennedy

Keyword(s):

Surgical Technique ◽

Blood Loss ◽

Lateral Ventricle ◽

Technical Note ◽

Intraoperative Blood Loss ◽

Prolonged Hospital Stay ◽

Tissue Sparing ◽

Surgical Corridor ◽

Prolonged Hospital ◽

Superficial Hemosiderosis

Hemispheric disconnection in the form of hemispherectomy or hemispherotomy is the most effective way of treating intractable hemispheric epilepsy. Anatomical hemispherectomy approaches have largely been abandoned in most cases due to a higher risk of superficial hemosiderosis, intraoperative blood loss, hydrocephalus, prolonged hospital stay, and mortality compared to the variety of tissue-sparing hemispherotomy techniques. Disconnective hemispherotomy approaches utilize the lateral ventricle as a key component of the surgical corridor. Without a lateral ventricle, disconnective surgery becomes significantly challenging, typically leading to a hemispherectomy. The authors present the case of a patient with severe hemispheric dysplasia without a lateral ventricle on the pathologic side and detail a novel surgical technique for a prone, occipital interhemispheric, tissue-sparing, purely disconnective aventricular hemispherotomy with an excellent surgical outcome.

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Third ventriculostomy through the lamina terminalis for intracranial pressure monitoring after aneurysm surgery: technical note

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2002000600009 ◽

2002 ◽

Vol 60 (4) ◽

pp. 932-934 ◽

Cited By ~ 4

Author(s):

Jorge L. Kraemer ◽

Pedro L. Gobbato ◽

Yuri M. Andrade-Souza

Keyword(s):

Intracranial Pressure ◽

Drainage System ◽

Technical Note ◽

Acute Stage ◽

Third Ventriculostomy ◽

Ventricular Catheter ◽

Lamina Terminalis ◽

Aneurysm Surgery ◽

External Drainage ◽

Csf Drainage

OBJECTIVE: A new ventriculostomy technique through the lamina terminalis is described. This technique is applied mainly during aneurysm surgery at the acute stage. METHOD: Thirteen patients were operated on intracranial aneurysms and, during the procedure, had the lamina terminalis fenestrated. A ventricular catheter was inserted into the third ventricule, left in place and connected to an external drainage system for further intracranial pressure (ICP) monitoring and/or cerebrospinal fluid (CSF) drainage. RESULTS: ICP readings and CSF drainage were obtained in all cases. No complication was recorded. CONCLUSION: Third ventriculostomy through the lamina terminalis is a simple and easy technique that can be used as an alternative to conventional ventriculostomy. This procedure can be indicated in cases where the ventricule is not reached by means of another technique, and when the decision to perform ventriculostomy is made at the end of aneurysm surgery.

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