World Neurosurg
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There are potentially 100,000 to 200,000 new cases of infant hydrocephalus each year in sub-Saharan Africa alone. The difficulty of accessing urgent neurosurgical care in this region substantially magnifies the risk of serious morbidity and death from shunt malfunction. Endoscopic third ventriculostomy is an excellent treatment alternative to shunt placement, but its effectiveness in young infants is substantially reduced. ⋯ The broader impact of this technique on the management of pediatric hydrocephalus in the developing world will be dependent on demonstration of its success when implemented by other surgeons in different patient populations, and the extent to which this treatment paradigm is ultimately adopted.
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The almost age-old neuroendoscopy (NE) and neuronavigation (NN) in its twenties independently and indisputably have proved their high value as neurosurgical armamentarium and became even indispensable in some pathologies. However, nowadays the effectiveness of their simultaneous and combined application still is a matter of debate. The purpose of our pilot international, questionnaire-based survey was to assess the position of the opinion leaders in the field of neuroendoscopy worldwide toward the neuronavigational neuroendoscopy (NNNE). ⋯ NNNE represents a valuable operative technique with excellent future prospects. NNNE extends the range of neuroendoscopic procedures, transforming some number of patients from "nonoperable" neuroendoscopically to suitable for neuroendoscopy.
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This paper discusses indications for and the technique of endoscopic aqueductoplasty with stenting. ⋯ Aqueductoplasty with stenting is the procedure of choice for the treatment of isolated fourth ventricle. Membranous and tumor-related aqueductal stenosis should be treated by endoscopic third ventriculostomy.
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Generally, the sacrifice of arteries that perfuse normal brain parenchyma is avoided. However, there are instances when it is necessary to take certain distal arteries to adequately perform tumor resections or secure vascular lesions. Deciding whether the sacrifice of such arteries is safe can be difficult. ⋯ Although this is a limited experience and cannot prove the safety of arterial sacrifice in all situations, our series demonstrates the potential usefulness of ICG videoangiography in assessing collateral arterial flow before sacrifice of distal cerebral arteries.