The Incidence of Bradycardia During Endoscopic Third Ventriculostomy

Eldawlatly, Abdelazeem; Murshid, Waleed R.; Elshimy, Adel; Magboul, Magboul Ali; Samarkandi, Abdulhameed; Takrouri, Mohamed Said

doi:10.1097/00000539-200011000-00019

Cited by 31 publications

(33 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…3 Bradycardia was reported in 43% and 41% of the patients in two separate studies during fenestration of the third ventricle floor, 7,8 and in 26.8% of the patients during balloon inflation of a Fogarty catheter.…”

Section: Discussionmentioning

confidence: 96%

Avoidance and management of perioperative complications of endoscopic third ventriculostomy: the Dhaka experience

Kawsar

Haque

Chowdhury

2015

JNS

View full text Add to dashboard Cite

E ndoscopic third ventriculostomy (ETV) is an established therapeutic alternative to conventional shunt surgery for patients with noncommunicating hydrocephalus. 22 Neuroendoscopy has many advantages, including speed, simplicity, avoidance of implants, and avoidance of brain retraction or dissection. However, a variety of perioperative complications have been reported in ETV, attributed mostly to the unique surgical technique, which causes alterations in cerebral flow dynamics and injuries to vital brain areas. Previously reported complication rates range from 5% to 30%, and operative mortality is between 0% and 1%.22 Serious hemodynamic variations, temperature alterations, electrolyte imbalances, and delayed emergence from anesthesia after surgery are some of the complications that may adversely affect outcome. 1Sometimes difficult or unfavorable anatomy may result in procedure abandonment. A thorough understanding of complications resulting from different endoscopic maneuvers can aid complication management and substantially improve patient safety. In this paper we present our experience of operative and immediate postoperative complications that occurred during intraventricular neuroendo scopy at Dhaka Medical College Hospital and other private hospitals in Dhaka, Bangladesh. We also describe some novel but simple maneuvers that can be easily applied intraoperatively to avoid and manage complications. obJect Although endoscopic third ventriculostomy (ETV) is a minimally invasive procedure, serious perioperative complications may occur due to the unique surgical maneuvers involved. In this paper the authors report the complications of elective and emergency ETV and their surgical management in 412 patients from July 2006 to October 2012 at Dhaka Medical College Hospital (a government hospital) and other private hospitals in Dhaka, Bangladesh. The authors attempted some previously undescribed simple maneuvers that may help to overcome the difficulties of managing complications. methods The complication rate was determined by recording intraoperative changes in pulse and blood pressure, bleeding episodes, serum electrolyte abnormalities, CSF leakage, and neurological deterioration in the immediate postoperative period. results Intraoperative complications included hemodynamic alterations in the form of tachycardia, bradycardia, and hypertension. Bleeding was categorized as major in 2 cases and minor in 68 cases. Delayed recovery from anesthesia occurred in 14 cases, CSF leakage from the wound in 11 cases, and electrolyte imbalance in 5 cases. Postoperatively, 2 patients suffered convulsions and 1 had evidence of third cranial nerve injury. Three patients died as a result of complications. coNclusioNs Complications during endoscopy can lead to serious consequences that may sometimes be very difficult to manage. The authors have identified and managed a large number of complications in this series, although the rate of complications is consistent with that in other reported series. These complications should be ke...

show abstract

Section: Discussionmentioning

confidence: 96%

Avoidance and management of perioperative complications of endoscopic third ventriculostomy: the Dhaka experience

Kawsar

Haque

Chowdhury

2015

JNS

View full text Add to dashboard Cite

show abstract

“…A necessidade desse implante ocorreu em um dos pacientes em decorrência de sangramento de artérias perfurantes. Pode haver necessidade, ainda, de que se converta o procedimento em craniotomia aberta para eliminar o sangramento 10 . Além dessas complicações estão descritas na literatura: diabete insípido, síndrome de secreção inadequada de hormônio antidiurético, paralisia de nervos cranianos, sobretudo III e VI, atraso no despertar, confusão mental temporária, perda da memória, infecção, hemorragia, convulsões, cefaléia, pneumencéfalo e parada cardio-respiratória 8, 15,14,17 .…”

Section: Discussionunclassified

“…In this study, this happened to one of the patients due to bleeding of the perforating arteries. It can also be an indication to change the procedure to open craniotomy to eliminate the bleeding 10 . Besides those complications, there are repots in the literature of: diabetes insipidus, syndrome of inappropriate antidiuretic hormone secretion, paralysis of cranial nerves, especially III and VI, delayed awakening, transitory mental confusion, loss of memory, infection, hemorrhage, seizures, headache, pneumocephalus, and cardiorespiratory arrest 8,14,15,17 .…”

Section: Discussionmentioning

confidence: 99%

“…Entre as técnicas empregadas, a terceiro-ventriculostomia tem sido utilizada com freqüência no tratamento da hidrocefalia obstrutiva, presente em um número crescente de crianças prematuras ou com outras doenças graves, uma vez que elimina a necessidade de derivações ventriculoperitoneais 2,7 . Todavia, mesmo se tratando de uma técnica minimamente invasiva e de simples realização, com baixa morbidade e mortalidade, não está isenta de complicações perioperatórias 5,6,[8][9][10][11][12][13][14][15][16][17][18] , exigindo do anestesiologista familiaridade com tais eventos. O objetivo do presente trabalho foi relatar e discutir a conduta anestésica e as complicações perioperatórias da terceiro-ventriculostomia em uma serie de 38 crianças abaixo de 2 anos.…”

Section: Introductionunclassified

“…Among the techniques employed, third ventriculostomy has been used frequently in the treatment of obstructive hydrocephalus, found in increasing numbers in premature infants or in children with other severe diseases, because it eliminates the need for ventriculoperitoneal derivations 2,7 . However, despite being a minimally invasive technique, with low morbidity and mortality, it is not devoid of perioperative complications 5,6,[8][9][10][11][12][13][14][15][16][17][18] , and the anesthesiologist should be knowledgeable on such matters. The aim of this study was to report and discuss the anesthetic conduct and perioperative complications of third ventriculostomy in a series of 38 children younger than 2 years.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Anestesia para ventriculostomia por via endoscópica para tratamento de hidrocefalia: relato de casos

Valadares¹,

Lorentz²,

Heyden³

et al. 2007

Rev. Bras. Anestesiol.

View full text Add to dashboard Cite

Complicações observadas: disritmias cardíacas sem repercussão hemodinâmica no intra-operatório (seis casos). Dois pacientes tiveram sangramento intra-operatório, mas somente um deles demandou implante de derivação ventricular externa. As complicações no pós-operatório foram: vômitos (6), picos febris (4) convulsões (2), laringoespasmo (1) e estridor laríngeo (1). CONCLUSÕES:A terceiro-ventriculostomia apresenta baixa incidência de complicações mesmo em pacientes com menos de 24 meses, desde que sejam adotadas técnicas anestésicas e cirúr-gicas adequadas.

show abstract

Anatomy of the floor of the third ventricle in relation to endoscopic ventriculostomy

et al. 2009

View full text Add to dashboard Cite

Neuroanatomical structures that form the floor of the third ventricle (FTV) and neighboring tissues are important in the context of third ventriculostomy (TV) procedures. Thorough knowledge of the anatomical and histological organization of the region would be useful in understanding and preventing surgical complications. Taking the third ventricle region as a model, we aimed to simulate TV and make measurements of 23 cadaver brains, as well as perform histological examinations of the third ventricular floor on five cadaver brains. During the endoscopic TV, we examined the degree to which the structures surrounding the FTV were affected by surgical simulation. To make a clinical comparison, the distance between the center of the FTV and the basilar apex was measured on cranial magnetic resonance images (MRIs) of 15 subjects with normal ventricular systems and 15 subjects with moderately enlarged ventricles. Histological examination revealed that the ependymal cells and arachnoid membrane formed the inner and outer surfaces of the third ventricle floor, respectively, whereas the stroma was made up of glial cells exclusively. This region was gliotic and avascular. When cadaver brains with normal and hydrocephalic ventricles were compared, there were significant differences in the distance between the center of the floor and the basilar apex (P < 0.001). On the basis of our study, the optimal site for TV fenestration and balloon inflation is just anterior to the mamillary bodies to avoid injury to neighboring structures.

show abstract

The Incidence of Bradycardia During Endoscopic Third Ventriculostomy

Cited by 31 publications

References 7 publications

Avoidance and management of perioperative complications of endoscopic third ventriculostomy: the Dhaka experience

Avoidance and management of perioperative complications of endoscopic third ventriculostomy: the Dhaka experience

Anestesia para ventriculostomia por via endoscópica para tratamento de hidrocefalia: relato de casos

Anatomy of the floor of the third ventricle in relation to endoscopic ventriculostomy

Contact Info

Product

Resources

About