Endoscopic third ventriculostomy in adults: a technique for dealing with the neural (opaque) floor

Grand, Walter; Leonardo, Jody

doi:10.3171/2010.10.jns101000

Cited by 12 publications

(12 citation statements)

References 33 publications

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“…The technique can be augmented by the use of neuronavigation or stereotactic guidance [2, 4]. The most common difficulties associated with the surgery are narrow space between mammillary bodies and dorsum sellae, high localization of basal artery bifurcation, and opaque floor of the third ventricle bulging to the sellae [12]. According to Bouras, who conducted a review on complications of ETV, the overall complication rate was 8.8%.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic third ventriculostomy in treatment of hydrocephalus.

Sokal¹,

Birski²,

Rusinek³

et al. 2012

Videosurgery and Other Miniinvasive Techniques

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IntroductionEndoscopic third ventriculostomy (ETV) is a minimally invasive method of treatment of obstructive hydrocephalus (HCP).AimTo investigate perioperative and intraoperative difficulties, failures and complications of ETV.Material and methodsSeventy-three procedures of ETV were conducted in our department in the last 5 years on 69 patients with HCP of different etiology. In 4 patients we performed ETV twice. In 4 cases we used neuronavigation. In 6 cases ETV was performed in conjunction with endoscopic biopsy of the tumor. In 6 cases we had to repeat the procedure (4) or implant a ventriculo-peritoneal shunt (2) due to recurrence of symptoms.ResultsIn our series we had 3 important complications: one thalamic injury and 2 intraventricular hemorrhages. In 4 cases we observed postoperative hyperthermia with the presence of meningeal symptoms. Two cerebrospinal fluid (CSF) leaks were secured with additional stitches and 2 CSF infections were treated with antibiotics. In 1 patient epileptic seizers were observed. Three others complained of nausea and vomiting. The initial success rate of ETV is 70%.ConclusionsBased on our material we conclude that ETV is a useful and helpful procedure in non-communicating HCP. It carries 4% perioperative risk of serious complications which can be reduced by proper selection of patients, detailed plan and skilful performance of surgery in experienced hands and meticulous postoperative care.

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Section: Discussionmentioning

confidence: 99%

Endoscopic third ventriculostomy in treatment of hydrocephalus.

Sokal¹,

Birski²,

Rusinek³

et al. 2012

Videosurgery and Other Miniinvasive Techniques

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Section: Clinical Significancementioning

confidence: 99%

“…The most often cited clinical application is its role during endoscopic third ventriculocisternostomies (ETVs) [7,11,23]. There have been many articles which approached this topic and most of these mention the necessity to open the membrane of Liliequist during endoscopic ventriculostomy procedures [7,11,23]. Grand et al describe a "cookie cutter" technique (whereby a 4.6-mm irrigating sheath was used to press and core ("cookie cut") a section of the tuber cinereum) in the opaque floor type of the third ventricle and also insist on the importance of checking to see if there are remnants of the membrane which might block the flow of CSF [11].…”

Section: Clinical Significancementioning

confidence: 99%

“…There have been many articles which approached this topic and most of these mention the necessity to open the membrane of Liliequist during endoscopic ventriculostomy procedures [7,11,23]. Grand et al describe a "cookie cutter" technique (whereby a 4.6-mm irrigating sheath was used to press and core ("cookie cut") a section of the tuber cinereum) in the opaque floor type of the third ventricle and also insist on the importance of checking to see if there are remnants of the membrane which might block the flow of CSF [11]. In case the posterior cerebral artery P1 segment (pre-communicating) is present at the level of the area to be perforated in ETV procedures [7], the cookie cut technique is also a way to avoid injury to the P1 segment.…”

Section: Clinical Significancementioning

confidence: 99%

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The membrane of Liliequist—a safe haven in the middle of the brain. A narrative review

et al. 2020

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Background The membrane of Liliequist is one of the best-known inner arachnoid membranes and an essential intraoperative landmark when approaching the interpeduncular cistern but also an obstacle in the growth of lesions in the sellar and parasellar regions. The limits and exact anatomical description of this membrane are still unclear, as it blends into surrounding structures and joins other arachnoid membranes. Methods We performed a systematic narrative review by searching for articles describing the anatomy and the relationship of the membrane of Liliequist with surrounding structures in MEDLINE, Embase and Google Scholar. Included articles were crosschecked for missing references. Both preclinical and clinical studies were included, if they detailed the clinical relevance of the membrane of Liliequist.Results Despite a common definition of the localisation of the membrane of Liliequist, important differences exist with respect to its anatomical borders. The membrane appears to be continuous with the pontomesencephalic and pontomedullary membranes, leading to an arachnoid membrane complex around the brainstem. Furthermore, Liliequist's membrane most likely continues along the oculomotor nerve sheath in the cavernous sinus, blending into and giving rise to the carotid-oculomotor membrane. Conclusion Further standardized anatomical studies are needed to clarify the relation of the membrane of Liliequist with surrounding structures but also the anatomy of the arachnoid membranes in general. Our study supports this endeavour by identifying the knowledge hiatuses and reviewing the current knowledge base.

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“…In the procedure a metal endoscope is introduced into the lateral ventricle. 6,7) However, these operations can result in Stab wound injury (SWI) which is a kind of TBI. All the patients studied in these research presented intracranial hypertension or other neurological Symptoms, some patients even lost the cognitive competence totally.…”

mentioning

confidence: 99%

Osthole Enhances the Therapeutic Efficiency of Stem Cell Transplantation in Neuroendoscopy Caused Traumatic Brain Injury

Tao

Gao

Yan

et al. 2017

Biological & Pharmaceutical Bulletin

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Neuroendoscopy processes can cause severe traumatic brain injury. Existing therapeutic methods, such as neural stem cell transplantation and osthole have not been proven effective. Therefore, there is an emerging need on the development of new techniques for the treatment of brain injuries. In this study we propose to combine the above stem cell based methods and then evaluate the efficiency and accuracy of the new method. Mice were randomly divided into four groups: group 1 (brain injury alone); group 2 (osthole); group 3 (stem cell transplantation); and group 4 (osthole combined with stem cell transplantation). We carried out water maze task to exam spatial memory. Immunocytochemistry was used to test the inflammatory condition of each group, and the differentiation of stem cells. To evaluate the condition of the damaged blood brain barrier restore, we detect the Evans blue (EB) extravasation across the blood brain barrier. The result shows that osthole and stem cell transplantation combined therapeutic method has a potent effect on improving the spatial memory. This combined method was more effective on inhibiting inflammation and preventing neuronal degeneration than the single treated ones. In addition, there was a distinct decline of EB extravasation in the combined treatment groups, which was not observed in single treatment groups. Most importantly, the combined usage of osthole and stem cell transplantation provide a better treatment for the traumatic brain injury caused by neuroendoscopy. The collective evidence indicates osthole combined with neural stem cell transplantation is superior than either method alone for the treatment of traumatic brain injury caused by neuroendoscopy.

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Endoscopic third ventriculostomy in adults: a technique for dealing with the neural (opaque) floor

Cited by 12 publications

References 33 publications

Endoscopic third ventriculostomy in treatment of hydrocephalus.

Endoscopic third ventriculostomy in treatment of hydrocephalus.

The membrane of Liliequist—a safe haven in the middle of the brain. A narrative review

Osthole Enhances the Therapeutic Efficiency of Stem Cell Transplantation in Neuroendoscopy Caused Traumatic Brain Injury

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