医学
导管
脑积水
内窥镜
镶边技术
外科
内窥镜检查
脑室出血
脑室造瘘术
第四脑室
调车
心室
放射科
心脏病学
生物
胎龄
怀孕
遗传学
作者
Lacey M. Carter,Naina L. Gross
出处
期刊:Operative Neurosurgery
[Oxford University Press]
日期:2021-06-25
卷期号:21 (4): E304-E308
被引量:2
摘要
Neonatal intraventricular hemorrhage remains a significant source of morbidity in premature and low-weight patients. Approximately 15% of patients who require cerebrospinal fluid shunting develop trapped fourth ventricle (TFV). Surgical treatment presents challenges with short- and long-term complications.To describe a technique that applies the Seldinger technique with image-guided endoscopy for direct visualization of catheter placement.A guidewire is passed down the endoscope while it is positioned in the fourth ventricle. The endoscope is removed while the guidewire is held in place. The catheter is slid down the guidewire. The guidewire is removed and placement is confirmed with image guidance.Three patients, all less than 14 mo old, with history of prematurity and intraventricular hemorrhage with ventriculoperitoneal shunts, presented with loculated hydrocephalus with TFV. They each underwent image-guided endoscopic fenestration of the fourth ventricle with placement of a fourth ventricular catheter performed by our described technique. All 3 patients recovered well and were discharged on postoperative day 1. Follow-up imaging showed decompression of the fourth ventricle and good placement of the fourth ventricular catheter. None have had complications from catheter placement, and one revision of a fourth ventricular catheter was needed, which was completed with the same described technique.This technique is well suited for cases in which a fourth ventricular catheter or a difficult trajectory catheter is needed during endoscopic fenestration or when distorted anatomy is present that would make a straight trajectory with a pen endoscope more difficult or higher risk.
科研通智能强力驱动
Strongly Powered by AbleSci AI