Avoiding Complicated Shunt Systems by Open Fenestration of Symptomatic Fourth Ventricular Cysts Associated with Hydrocephalus

Villavicencio, Alan T.; Wellons, John C.; George, Timothy M.

doi:10.1159/000028745

Cited by 55 publications

(20 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The management of DWS has been heavily debated, and treatment options range from craniotomy with cyst fenestration or excision to CSF shunting procedures [3,4,5,6,7,8,9,10,11,12]. While open cyst fenestration has gained recent proponents [12], ventriculoperitoneal (VPS) and/or cystoperitoneal shunting (CPS) remain the mainstays of treatment [3,4,5,6,7,8,9,10,11].…”

Section: Discussionmentioning

confidence: 99%

“…While open cyst fenestration has gained recent proponents [12], ventriculoperitoneal (VPS) and/or cystoperitoneal shunting (CPS) remain the mainstays of treatment [3,4,5,6,7,8,9,10,11]. According to the literature, combined VPS and CPS is needed for satisfactory decompression of the Dandy-Walker cyst and hydrocephalus in 16 and 92% of all cases [13].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic, Single-Catheter Treatment of Dandy-Walker Syndrome Hydrocephalus: Technical Case Report and Review of Treatment Options

Sikorski¹,

Curry²

2005

Pediatr Neurosurg

View full text Add to dashboard Cite

Optimal treatment for hydrocephalus related to Dandy-Walker syndrome (DWS) remains elusive. Patients with DWS-related hydrocephalus often require combinations of shunting systems to effectively drain both the supratentorial ventricles and posterior fossa cyst. We describe an endoscopic technique, whereby a frontally placed, single-catheter shunting system effectively drained the supratentorial and infratentorial compartments. This reduces the complexity and potential risk associated with the combined shunting systems required by so many with DWS-related hydrocephalus.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endoscopic, Single-Catheter Treatment of Dandy-Walker Syndrome Hydrocephalus: Technical Case Report and Review of Treatment Options

Sikorski¹,

Curry²

2005

Pediatr Neurosurg

View full text Add to dashboard Cite

show abstract

“…Many institutions, such as ours, have favored initial cyst fenestration, usually into the basal cisterns. 4,7,8,11,13,14,16,21,23,25,28 Other centers have advocated the placement of CP shunts as a primary treatment for these cysts. 3,27 The clinical presentation of patients with arachnoid cysts, especially during the first few years of life, may offer considerable insight into the relationship between these lesions and underlying aberrancies in CSF flow.…”

mentioning

confidence: 99%

Pathogenesis and treatment of intracranial arachnoid cysts in pediatric patients younger than 2 years of age

Zada

Krieger²,

McNatt³

et al. 2007

FOC

View full text Add to dashboard Cite

Object Arachnoid cysts can cause a variety of clinical signs and symptoms in infants. The authors sought to determine whether the clinical presentation of pediatric patients younger than 2 years old and harboring arachnoid cysts influenced the type of intervention that would be required. Methods A retrospective chart review was conducted for all patients younger than 2 years of age who had undergone craniotomy for fenestration of an arachnoid cyst at the Childrens Hospital Los Angeles between 1995 and 2006. Forty-two patients were included in the study. The mean age was 10.4 months. The median follow-up time was 33 months. Clinical presentations were as follows: macrocephaly without ventriculomegaly (21 patients, 50%), hydrocephalus (six patients, 14%), and other symptoms (15 patients, 36%). After fenestration of the arachnoid cyst, 12 of 21 patients (57%) presenting with nonspecific macrocephaly required placement of a cystoperitoneal or ventriculoperitoneal shunt, compared with 1 of 15 patients (7%) presenting with other symptoms (p value = 0.0039). Five of six patients with hydrocephalus (83%) were shunt dependent following fenestration. Overall, 18 of 42 patients (43%) were shunt dependent after fenestration. Ten of these patients (55%) required revisions during the follow-up period. Conclusions Patients younger than 2 years of age and harboring an arachnoid cyst commonly present with macrocephaly. These patients are more likely to require shunts than are those presenting with other findings, such as seizu

show abstract

“…19,25,33 While the neurosurgical treatment armamentarium has broadened to include open surgery, CSF diversion, and endoscopic techniques, serious complications ranging from cranial nerve to brainstem dys- function as well as a high rate of failure often hinder a complete cure. 1,3,5,14,20,36 In the present series, the 3 surgical patients all required multiple revision surgeries after fourth ventricular shunt placement. Specifically, the 2 patients who initially underwent endoscopic fenestration procedures ultimately underwent 4 total procedures related to the fourth ventricle.…”

Section: Discussionmentioning

confidence: 72%

Frequency and long-term follow-up of trapped fourth ventricle following neonatal posthemorrhagic hydrocephalus

Pomeraniec

Ksendzovsky

Ellis

et al. 2016

PED

View full text Add to dashboard Cite

OBJECTIVE Intraventricular hemorrhage (IVH) is a common complication of premature neonates with small birth weight, which often leads to hydrocephalus and treatment with ventriculoperitoneal (VP) shunting procedures. Trapped fourth ventricle (TFV) can be a devastating consequence of the subsequent occlusion of the cerebral aqueduct and foramina of Luschka and Magendie. METHODS The authors retrospectively reviewed 8 consecutive cases involving pediatric patients with TFV following VP shunting for IVH due to prematurity between 2003 and 2012. The patients ranged in gestational age from 23.0 to 32.0 weeks, with an average age at first shunting procedure of 6.1 weeks (range 3.1–12.7 weeks). Three patients were managed with surgery. Patients received long-term radiographic (mean 7.1 years; range 3.4–12.2 years) and clinical (mean 7.8 years; range 4.6–12.2 years) follow-up. RESULTS The frequency of TFV following VP shunting for neonatal posthemorrhagic hydrocephalus was found to be 15.4%. Three (37.5%) patients presented with symptoms of posterior fossa compression and were treated surgically. All of these patients showed signs of radiographic improvement with stable or improved clinical examinations during postoperative follow-up. Of the 5 patients treated conservatively, 80% experienced stable ventricular size and 1 patient experienced a slight increase (3 mm) on imaging. All of the nonsurgical patients showed stable to improved clinical examinations over the follow-up period. CONCLUSIONS The frequency of TFV among premature IVH patients is relatively high. Most patients with TFV are asymptomatic at presentation and can be managed without surgery. Symptomatic patients may be treated surgically for decompression of the fourth ventricle.

show abstract

Avoiding Complicated Shunt Systems by Open Fenestration of Symptomatic Fourth Ventricular Cysts Associated with Hydrocephalus

Cited by 55 publications

References 28 publications

Endoscopic, Single-Catheter Treatment of Dandy-Walker Syndrome Hydrocephalus: Technical Case Report and Review of Treatment Options

Endoscopic, Single-Catheter Treatment of Dandy-Walker Syndrome Hydrocephalus: Technical Case Report and Review of Treatment Options

Pathogenesis and treatment of intracranial arachnoid cysts in pediatric patients younger than 2 years of age

Frequency and long-term follow-up of trapped fourth ventricle following neonatal posthemorrhagic hydrocephalus

Contact Info

Product

Resources

About