World Neurosurg
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Review Meta Analysis Historical Article
A history of ventricular neuroendoscopy.
To describe the history of neuroendoscopy through the history of the major neurosurgeons who worked and published in the field. ⋯ An historical review of ventricular neuroendoscopy remains by essence incomplete. Medical technical progress proceeds by leaps and bounds, related to the ingenuity of surgeons able to understand rapidly the value of a technical change to improve their surgical procedure. The ability to remain attentive to patients and evolving pathologies as well as the evolution of modern technology is required to make further progress in neuroendoscopy.
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The treatment of choice for several types of obstructive hydrocephalus is endoscopic third ventriculostomy (ETV). However, in certain cases ETV is not clearly superior to shunt placement, and a question of choice arises. Apart from the possibility of success in each case, knowledge of complication rates is of major importance as well. ⋯ The complication rate of ETV is low, and rarely is a reason for choosing shunt placement instead. However, as a method it requires considerable experience, and several studies report a relation of experience not only with success rates but also with complication avoidance.
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Review Meta Analysis
Is external cervical orthotic bracing necessary after posterior atlantoaxial fusion with modern instrumentation: meta-analysis and review of literature.
No guidelines exist regarding external cervical orthoses (ECO) after atlantoaxial fusion. We reviewed published series describing C1-2 posterior instrumented fusions with screw-rod constructs (SRC) or transarticular screws (TAS) and compared rates of fusion with and without postoperative ECO. ⋯ After C1-2 fusion with modern instrumentation, ECO may be unnecessary (class III). Some centers recommend ECO use with patients with softer bone quality (class IV). Prospective, randomized studies with validated radiographic and clinical outcome metrics are necessary to determine the utility of ECO after C1-2 fusion and its impact on patient comfort and cost.
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The first case of an intracranial arachnoid cyst was described by Bright in 1831. In 1935, Barlow published the first case of a suprasellar arachnoid cyst. Fewer than 200 cases of suprasellar-prepontine arachnoid cysts have been reported in the literature as of January 2011. ⋯ Suprasellar arachnoid cysts can be treated with favorable clinical and radiological results with endoscopic interventions when feasible. Results with ventriculocystocisternostomy are believed superior to those of ventriculocystostomy.
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Review Case Reports
Endoneurosurgical resection of intraventricular and intraparenchymal lesions using the port technique.
Deep-seated intraventricular and intraparenchymal lesions have traditionally been resected via transcortical routes, often requiring the use of retractors to maintain the corridor created to reach the lesion and proceed with a bimanual microsurgical resection. A transparent cylindrical conduit (port) has been developed to resect deep-seated lesions using the endoscope or, more recently, Video Telescopic Operating Microscopy (VTOM) for visualization. We describe the surgical technique of the port technique and discuss the evolution of the concept of intraaxial brain surgery performed through a conduit. ⋯ The port technique is an option for resection of intraventricular and intraparenchymal lesions. Additional studies are required to assess its impact on adjacent cerebral tissue morphology, blood flow, and metabolism. Quality-of-life assessments are also needed. High-definition fiber tracking, new visualization techniques (VTOM), and new instrumentation will add to the progress of endoscopic port surgery. We have already seen a significant evolution of the technology even since the preparation of this article.