Minim Invas Neurosur
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Minim Invas Neurosur · Aug 2007
Case ReportsUse of 3DFT-CISS sequences and virtual MR endoscopy for the neuroendoscopic treatment of unilateral hydrocephalus: case illustration.
Intraventricular virtual MR endoscopic imaging of the foramen of Monro region by using three-dimensional Fourier transformation constructive interference in steady state (3DFT-CISS) magnetic resonance imaging in a patient with a unilateral congenital obstruction of the foramen of Monro by a transparent membranous septum was performed to enhance the orientation, achieve a better understanding of the pathology, and plan the surgical intervention in an endoscopic approach to the lateral ventricles. ⋯ Virtual MR endoscopy by using 3DFT-CISS sequences is a feasible method in the planning of intraventricular real-time endoscopic surgery, for the enhancement of orientation in a surgical field, and to achieve a better understanding of the pathology.
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Minim Invas Neurosur · Aug 2007
Case ReportsCombined endoscopically guided third ventriculostomy with prepontine cistern placement of the ventricular catheter in a ventriculo-peritoneal shunt: technical note.
The authors present the management of non-obstructive hydrocephalus using two surgical procedures, both at the same time: first, we perform an endoscopic third ventriculostomy and second, we place the ventricular catheter of the ventriculo-peritoneal shunt in the prepontine cistern under endoscopic guidance. The main rationale is the fact that the ventricular catheter passes through multiple fixed cerebrospinal fluid circulation points in order to allow the free circulation of the cerebrospinal liquid. The authors present here details of the technique and short-term results.
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Minim Invas Neurosur · Aug 2007
Pterional keyhole approach to middle cerebral artery aneurysms through an outer canthal skin incision.
The supraorbital keyhole approach via an eyebrow skin incision provides a method for the minimally invasive clipping of aneurysms located in the circle of Willis, but has disadvantages for aneurysms located in the lateral Sylvian fissure. The pterional keyhole minicraniotomy via an outer canthal skin incision is proposed for the clipping of unruptured aneurysms of the middle cerebral artery (MCA). ⋯ The pterional keyhole approach via outer an canthal skin incision is another treatment option for relatively small, unruptured MCA aneurysms.
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Minim Invas Neurosur · Aug 2007
Multiple brain tumor nodule resections under direct visualization of a neuronavigated endoscope.
With neuronavigation-assistance, endoscopic neurosurgery has a variety of advantages for brain tumor resection. However, intraoperative neuronavigation has to be operated by frequently alternating a neuronavigation wand and moving the microscope back-and-forth on the surgical field while the microscope is being used for surgery, except when using stereo overlays in the operating microscope aligned to the operative scene. In our practice, our surgical endoscope was used as a sole optical device and was also calibrated as a virtual wand targeting to tumor nodules while the operation was being performed under its simultaneous visualization. This paper gives a brief description and technical report of applications of image-guided endoscopy in two cases with multiple tumor nodules. ⋯ The neuronavigated endoscope coordinates of the tip of endoscope, and the trajectory of targets, provide both 3D orientation and direct endoscopic visualization simultaneously, and present with the unique feature for solely endoscopic minimally invasive procedures, especially for multiple intracranial lesions.
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Minim Invas Neurosur · Aug 2007
A new full-endoscopic technique for cervical posterior foraminotomy in the treatment of lateral disc herniations using 6.9-mm endoscopes: prospective 2-year results of 87 patients.
Anterior cervical decompression and fusion (ACDF) is the standard procedure for operation of cervical disc herniations with radicular arm pain. Mobility-preserving posterior foraminotomy is the most common alternative in the case of a lateral localization of the pathology. Despite good clinical results, problems may arise due to traumatization of the access. ⋯ No serious surgical complications occurred. The recorded results show that the full-endoscopic posterior foraminotomy is a sufficient and safe supplement and alternative to conventional procedures when the indication criteria are fulfilled. At the same time, it offers the advantages of a minimally invasive intervention.