scholarly journals Neuroendoscopy: past, present, and future

2005 ◽  
Vol 19 (6) ◽  
pp. 1-5 ◽  
Author(s):  
Khan W. Li ◽  
Clarke Nelson ◽  
Ian Suk ◽  
George I. Jallo
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Third Ventriculostomy ◽  
Endoscopic Procedures ◽  
Technological Advances ◽  
The Future ◽  
The Brain ◽  
And Training

Neuroendoscopy began with a desire to visualize the ventricles and deeper structures of the brain. Unfortunately, the technology available to early neuroendoscopists was not sufficient in most cases for these purposes. The unique perspective that neuroendoscopy offered was not fully realized until key technological advances made reliable and accurate visualization of the brain and ventricles possible. After this technology was incorporated into the device, neuro-endoscopic procedures were rediscovered by neurosurgeons. Endoscopic third ventriculostomy and other related procedures are now commonly used to treat a wide array of neurosurgically managed conditions. A seemingly limitless number of neurosurgical applications await the endoscope. In the future, endoscopy is expected to become routine in modern neurosurgical practice and training.

One- vs Two-Burr-Hole Technique for Combined Endoscopic Third Ventriculostomy and Pineal Region Biopsy: Volumetric Analysis of Brain at Risk

2020 ◽  
Vol 19 (2) ◽  
pp. 175-180
Author(s):  
Brandon D Liebelt ◽  
Fangxiang Chen ◽  
Antonio Biroli ◽  
Xiaochun Zhao ◽  
Peter Nakaji
Keyword(s):  
At Risk ◽  
Endoscopic Third Ventriculostomy ◽  
Brain Parenchyma ◽  
Pineal Region ◽  
Burr Hole ◽  
Third Ventriculostomy ◽  
Tumor Biopsy ◽  
Burr Holes ◽  
The Brain ◽  
The Ideal

Abstract BACKGROUND Pineal region tumors are associated with the ventricular system. Endoscopic third ventriculostomy (ETV) is often performed at the same time as tumor biopsy. OBJECTIVE To investigate the volume of brain possibly undergoing injury and forniceal stretching during ETV and tumor biopsy. METHODS We performed a retrospective review of preoperative magnetic resonance imagings (MRIs) and computed tomography (CTs) of patients with pineal region masses and used volumetric image-guided navigation to simulate a 1-burr-hole vs a 2-burr-hole approach through the brain parenchyma. We compared the volumes of parenchyma and fornix at the risk of injury. RESULTS The ideal entry point for ETV using 2 burr holes was a mean ± standard deviation (SD) of 25.8 ± 6 mm from the midline and 11.4 ± 9 mm behind the coronal suture. The ideal entry point using 2 burr holes for tumor biopsy was 25.7 ± 8 mm from the midline and 53.7 ± 14 mm anterior to the coronal suture. With 1 burr hole, the mean ± SD volume of brain parenchyma at risk was 852 ± 440 mm3. The volume of brain parenchyma at risk with 2 burr holes was 2159 ± 474 mm3 (P < .001; paired t-test). The use of 1 burr hole predisposed the fornix to 14 ± 3 mm of possible stretch, which was minimized with the 2-burr-hole approach. CONCLUSION Using 1 burr hole for both the ETV and tumor biopsy is less likely to traumatize the brain parenchyma than using 2 burr holes. However, 1 burr hole predisposes the fornix to stretch injury. We recommend tailoring the entry to each patient according to their anatomy rather than using a 1-size-fits-all approach.

scholarly journals Endoscopic third ventriculostomy

2005 ◽  
Vol 19 (6) ◽  
pp. 1-4 ◽  
Author(s):  
George I. Jallo ◽  
Karl F. Kothbauer ◽  
I. Rick Abbott
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Obstructive Hydrocephalus ◽  
Third Ventricle ◽  
Significant Advance ◽  
Third Ventriculostomy ◽  
Successful Completion ◽  
Traditional Treatment ◽  
The Third ◽  
Technological Advances ◽  
Third Ventricle Floor

The traditional treatment for all forms of hydrocephalus has been the implantation of ventricular shunt systems; however, these systems have inherent tendencies toward complications such as malfunction and infection. A significant advance in the treatment of hydrocephalus has been the evolution of endoscopy. The recent technological advances in this field have led to a renewed interest in endoscopic third ventriculostomy as the treatment of choice for obstructive hydrocephalus. Although several different endoscopes are available, the authors favor a rigid one to perform a blunt fenestration of the third ventricle floor. This description of the technique stresses the nuances for successful completion of this procedure.

scholarly journals Endoscopic diagnosis of an MRI-occult, low-grade glioma with ependymal dissemination

2015 ◽  
Vol 16 (4) ◽  
pp. 377-382 ◽  
Author(s):  
Konstantinos Margetis ◽  
Prajwal Rajappa ◽  
William Cope ◽  
David Pisapia ◽  
Mark M. Souweidane
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Third Ventricle ◽  
Surgical Pathology ◽  
Third Ventriculostomy ◽  
Low Grade ◽  
The Third ◽  
The Brain ◽  
Tectal Glioma ◽  
Triventricular Hydrocephalus ◽  
Multiple Nodules

A 21-year-old man presented with triventricular hydrocephalus due to a tectal mass. He underwent an endoscopic third ventriculostomy, and multiple nodules were identified at the floor of the third ventricle intraoperatively. Surgical pathology of one of these lesions demonstrated that the tissue represented a low-grade astrocytoma. The case highlights the existing potential of neuroendoscopy to reveal neuroimaging-occult lesions, in spite of the significant advances of MRI. Furthermore, the combination of the age of the patient, the nonenhancing MRI appearance, and the multifocality of the lesions constitutes a rare and interesting neoplastic presentation within the brain. The constellation of findings likely represents dissemination of a low-grade tectal glioma via the CSF compartment.

A NEW MULTIPURPOSE VENTRICULOSCOPE

Neurosurgery ◽  
2008 ◽  
Vol 62 (2) ◽  
pp. 489-492 ◽  
Author(s):  
Henry W.S. Schroeder
Keyword(s):  
Endoscopic Treatment ◽  
Endoscopic Third Ventriculostomy ◽  
Third Ventriculostomy ◽  
Intraventricular Tumor ◽  
Tumor Biopsy ◽  
Endoscopic Procedures ◽  
Clot Removal ◽  
Adults And Children ◽  
Intraventricular Cyst

Abstract THIS ARTICLE DESCRIBES a new multipurpose ventriculoscope that combines the advantages of several neuroendoscopic systems that are already available and provides some new features. This system can be used for all intracranial endoscopic procedures, such as endoscopic third ventriculostomy, septum fenestration, foraminoplasty, aqueductoplasty, stenting, cyst fenestrations, intraventricular tumor biopsy or resection, or intraventricular cyst or clot removal. The ventriculoscope can be used in both adults and children. Because of its diameter, it is not designed for the endoscopic treatment of newborns.

scholarly journals Low-cost endoscopic third ventriculostomy simulator with mimetic endoscope

2018 ◽  
Vol 22 (2) ◽  
pp. 137-146 ◽  
Author(s):  
Richard Justin Garling ◽  
Xin Jin ◽  
Jianzhong Yang ◽  
Ahmad H. Khasawneh ◽  
Carolyn Anne Harris
Keyword(s):  
Open Source ◽  
Open Source Software ◽  
Endoscopic Third Ventriculostomy ◽  
Low Cost ◽  
Resident Training ◽  
Patient Specific ◽  
Third Ventriculostomy ◽  
3D Printer ◽  
Specific Subset ◽  
The Brain

OBJECTIVEHydrocephalus affects approximately 1 in 500 people in the US, yet ventricular shunting, the gold standard of treatment, has a nearly 85% failure rate. Endoscopic third ventriculostomy (ETV) is an alternative surgical approach for a specific subset of hydrocephalic patients, but can be limited by the inability of neurosurgical residents to practice prior to patient contact. The goal of this study was to create an affordable ETV model and endoscope for resident training.METHODSOpen-source software was used to isolate the skull and brain from the CT and MR images of a 2-year-old boy with hydrocephalus. A 3D printer created the skull and a 3D mold of the brain. A mixture of silicone and silicone tactile mutator was used to cast the brain mold prior to subsequent compression and shearing modulus testing. A mimetic endoscope was then created from basic supplies and a 3D printed frame. A small cohort of neurosurgical residents and attending physicians evaluated the ETV simulator with mimetic endoscope.RESULTSThe authors successfully created a mimetic endoscope and ETV simulator. After compression and shearing modulus testing, a silicone/Slacker ratio between 10:6 and 10:7 was found to be similar to that of human brain parenchyma. Eighty-seven percent of participants strongly agreed that the simulator was useful for resident training, and 93% strongly agreed that the simulator helped them understand how to orient themselves with the endoscope.CONCLUSIONSThe authors created an affordable (US$123, excluding 3D printer), easy-to-use ETV simulator with endoscope. Previous models have required expensive software and costly operative endoscopes that may not be available to most residents. Instead, this attempt takes advantage of open-source software for the manipulation and fabrication of a patient-specific mold. This model can assist with resident development, allowing them to safely practice use of the endoscope in ETV.

Neuroendoscopic treatment of arachnoid cysts of the quadrigeminal cistern: a series of 14 cases

2010 ◽  
Vol 6 (5) ◽  
pp. 489-497 ◽  
Author(s):  
Giuseppe Cinalli ◽  
Pietro Spennato ◽  
Laura Columbano ◽  
Claudio Ruggiero ◽  
Ferdinando Aliberti ◽  
...  
Keyword(s):  
Success Rate ◽  
Endoscopic Third Ventriculostomy ◽  
Endoscopic Procedure ◽  
Arachnoid Cysts ◽  
Shunt Revision ◽  
Third Ventriculostomy ◽  
Type I ◽  
Temporal Fossa ◽  
Endoscopic Procedures ◽  
Quadrigeminal Cistern

Object In this paper, the authors' goal was to evaluate the role of neuroendoscopy in the treatment of arachnoid cysts of the quadrigeminal cistern. Methods Between March 1995 and February 2008, 14 patients affected by arachnoid cysts of the quadrigeminal cistern were treated endoscopically. The cysts were classified according to their anatomical and radiological appearance. The most frequent form (Type I) extended infratentorially and supratentorially with a dumbbell shape. Type II cysts were confined to the infratentorial space and were associated with the most severe and acute form of hydrocephalus. Type III cysts presented a significant asymmetric expansion toward the temporal fossa. Ten patients underwent an endoscopic procedure as primary treatment and 4 as an alternative to shunt revision. In 6 cases, the first endoscopic procedure was ventriculocystostomy (VC) together with endoscopic third ventriculostomy (ETV). In the other 8 cases, the first endoscopic procedure was VC alone. Results In the 6 cases in which VC was performed with an ETV, the procedure was successful, and the patients did not require further surgery. Of the 8 cases in which the first endoscopic procedure performed was VC without ETV, 7 underwent reoperation. Four of these patients underwent endoscopic procedures (by reopening the obstructed VC and performing ETV or cystocisternostomy) 2, 4, 4, and 5 months later with final success in all cases. Three patients (all of whom were previously treated using ventriculo- or cystoperitoneal shunts) required shunt reimplantation (complete failure). Subdural collection developed in 1 case, which was managed by transient insertion of a subduroperitoneal shunt. Neurological and developmental outcomes were good except for 1 patient who did not show improvement in preoperative developmental delay. No transient or permanent morbidity or mortality was observed. Conclusions The analysis of this series suggests that arachnoid cysts of the quadrigeminal cistern and the associated hydrocephalus can be effectively treated by endoscopy; this approach allows the patient to be shunt independent in more than 78% of the cases. If endoscopy is used as first option, the success rate of endoscopic procedures observed in this series was 90%. Endoscopic third ventriculostomy should be associated with a VC to offer the highest success rate with a single procedure.

Catholicism and Cosmopolitanism: the Confluence of Three Catholic Scholars and the Cosmopolitan Democrats on State Sovereignty and the Future of Global Governance

2016 ◽  
Vol 3 (2) ◽  
pp. 37-51
Author(s):  
Matthew Bagot
Keyword(s):  
Global Governance ◽  
State Sovereignty ◽  
Current Debate ◽  
Past Century ◽  
Jacques Maritain ◽  
The Past ◽  
Technological Advances ◽  
The Future ◽  
Cosmopolitan Democracy ◽  
Catholic Tradition

One of the central questions in international relations today is how we should conceive of state sovereignty. The notion of sovereignty—’supreme authority within a territory’, as Daniel Philpott defines it—emerged after the Treaty of Westphalia in 1648 as a result of which the late medieval crisis of pluralism was settled. But recent changes in the international order, such as technological advances that have spurred globalization and the emerging norm of the Responsibility to Protect, have cast the notion of sovereignty into an unclear light. The purpose of this paper is to contribute to the current debate regarding sovereignty by exploring two schools of thought on the matter: first, three Catholic scholars from the past century—Luigi Sturzo, Jacques Maritain, and John Courtney Murray, S.J.—taken as representative of Catholic tradition; second, a number of contemporary political theorists of cosmopolitan democracy. The paper argues that there is a confluence between the Catholic thinkers and the cosmopolitan democrats regarding their understanding of state sovereignty and that, taken together, the two schools have much to contribute not only to our current understanding of sovereignty, but also to the future of global governance.

PELAKSANAAN PENDIDIKAN DAN PELATIHAN (DIKLAT) DALAM RANGKA PENINGKATAN KINERJA PERSONIL YANG BERANEKARAGAM

2019 ◽  
Author(s):  
Puja Ningsih
Keyword(s):  
Continuous Improvement ◽  
Education And Training ◽  
The Future ◽  
And Training

Research and surveys have been conducted to find out data and information on the implementation of education and training (DIKLAT) in order to improve the performance of diverse personnel. Basically the implementation of education and training is intended to increase the mastery of the skills and knowledge of personnel in an effort to improve personnel performance. Measuring the performance of diverse personnel is important in overall management, in order to know each personnel's performance and find the best alternative for all deficiencies, because each personnel hasdifferent abilities and personalities.Performance measurements carried out on an ongoing basis provide feedback which is important in continuous improvement efforts in achieving success in the future.

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