Top

Published in:

07-06-2023 | Hydrocephalus | How I Do it

Neuronavigated endoscopic aqueductoplasty with panventricular stent plus septostomy for isolated fourth ventricle in complex hydrocephalus and syringomyelia associated with myelomeningocele: how I do it

Authors: José Javier Guil-Ibáñez, Tesifón Parrón-Carreño, Mario Gomar-Alba, José María Narro-Donate, José Masegosa-González

Published in: Acta Neurochirurgica | Issue 8/2023

Abstract

Background

Isolated fourth ventricle (IFV) is a challenging entity to manage. In recent years, endoscopic treatment for aqueductoplasty has been on the rise. However, in patients with complex hydrocephalus and distorted ventricular system, its implementation can be complex.

Methods

We present a 3-year-old patient with myelomeningocele and postnatal hydrocephalus treated by ventriculoperitoneal shunt. In follow-up, a progressive IFV and isolated lateral ventricle with symptoms of the posterior fossa developed. An endoscopic aqueductoplasty (EA) with panventricular stent plus septostomy guided with neuronavigation was decided due to the complexity of the ventricular system.

Conclusion

In IFV associated with complex hydrocephalus with distortion of the ventricular system, navigation can be of great help for planning and as a guide for performing EA.

Available only for authorised users

Fritsch MJ, Schroeder HW (2013) Endoscopic aqueductoplasty and stenting. World Neurosurg 79(2 Suppl):S20.e15–S20.e18CrossRefPubMed

Gomar-Alba M, Parrón-Carreño T, Guil-Ibáñez JJ, Vargas-López AJ, Castelló-Ruiz MJ, García-Pérez F, Masegosa-González J (2023) Role of endoscopic aqueductoplasty with panventricular stent in the treatment of isolated fourth ventricle during shunt malfunction: 2-dimensional operative video. Oper Neurosurg (Hagerstown). https://doi.org/10.1227/ons.0000000000000682 Advance online publication

Harter DH (2004) Management strategies for treatment of the trapped fourth ventricle. Childs Nerv Syst 20(10):710–716PubMed

Longatti P, Fiorindi A, Perin A, Martinuzzi A (2007) Endoscopic anatomy of the cerebral aqueduct. Neurosurgery 61(3 Suppl):1–6PubMed

Panagopoulos D, Karydakis P, Themistocleous M (2021) The entity of the trapped fourth ventricle: a review of its history, pathophysiology, and treatment options. Brain Circ 7(3):147–158CrossRefPubMedPubMedCentral

Pomeraniec IJ, Ksendzovsky A, Ellis S, Roberts SE, Jane JA Jr (2016) Frequency and long-term follow-up of trapped fourth ventricle following neonatal posthemorrhagic hydrocephalus. J Neurosurg Pediatr 17(5):552–557CrossRefPubMed

Rekate HL (2005) Endoscopic fourth ventricular aqueductoplasty. J Neurosurg 103(5):773–775CrossRefPubMed

Sagan LM, Kojder I, Poncyljusz W (2006) Endoscopic aqueductal stent placement for the treatment of a trapped fourth ventricle. J Neurosurg 105(4 Suppl):275–280PubMed

Schroeder HW, Gaab MR (1999) Endoscopic aqueductoplasty: technique and results. Neurosurgery 45(3):508–518CrossRefPubMed

10.

Schulz M, Goelz L, Spors B, Haberl H, Thomale UW (2012) Endoscopic treatment of isolated fourth ventricle: clinical and radiological outcome. Neurosurgery 70(4):847–859CrossRefPubMed

11.

Tirado-Caballero J, Rivero-Garvia M, Moreno-Madueño G, Gómez-González E, Márquez-Rivas J (2021) Cranial expansion and aqueductoplasty for combined isolated fourth ventricle and slit-ventricle syndrome: a surgical alternative. Childs Nerv Syst 37(3):885–894CrossRefPubMed

12.

Tirado-Caballero J, Herreria-Franco J, Rivero-Garvía M, Moreno-Madueño G, Mayorga-Buiza MJ, Marquez-Rivas J (2021) Technical nuances in neuroendoscopic lavage for germinal matrix hemorrhage in preterm infants: twenty tips and pearls after more than one hundred procedures. Pediatr Neurosurg 56(4):392–400. https://doi.org/10.1159/000516183CrossRefPubMed

Title: Neuronavigated endoscopic aqueductoplasty with panventricular stent plus septostomy for isolated fourth ventricle in complex hydrocephalus and syringomyelia associated with myelomeningocele: how I do it
Authors: José Javier Guil-Ibáñez
Tesifón Parrón-Carreño
Mario Gomar-Alba
José María Narro-Donate
José Masegosa-González
Publication date: 07-06-2023
Publisher: Springer Vienna
Keywords: Hydrocephalus
Hydrocephalus
Hydrocephalus
Syringomyelia
Published in: Acta Neurochirurgica / Issue 8/2023
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-023-05649-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Neuronavigated endoscopic aqueductoplasty with panventricular stent plus septostomy for isolated fourth ventricle in complex hydrocephalus and syringomyelia associated with myelomeningocele: how I do it

Abstract

Background

Methods

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Conclusion

Please log in to get access to this content

Other articles of this Issue 8/2023

Machine learning algorithms for improved prediction of in-hospital outcomes after moderate-to-severe traumatic brain injury: a Chinese retrospective cohort study

Is the presence of foraminal stenosis associated with outcome in lumbar spinal stenosis patients treated with posterior microsurgical decompression

From the perspective of pseudo-progression rather than treatment failure, how long should we wait before considering treatment failure if large cystic enlargement occurs after Gamma Knife radiosurgery for vestibular schwannoma? Insight into pseudo-progression based on two case reports

How I do it: epidural transposition of the temporoparietal fascia flap for anterior skull base reconstruction

Toward global availability of low-cost, patient-specific cranial implants: creation and validation of automated CranialRebuild freeware application

Physician experience improves ability to predict 6-month functional outcome of severe traumatic brain injury