Endoscopic Procedures for Management of Ventriculo- Peritoneal Shunt Malfunction and Malposition: Preliminary Results in 12 Consecutive Cases
|
|
- Anastasia Logan
- 5 years ago
- Views:
Transcription
1 Original Article Endoscopic Procedures for Management of Ventriculo- Peritoneal Shunt Malfunction and Malposition: Preliminary Results in 12 Consecutive Cases Hazem Mostafa Kamal Department of Neurosurgery, Cairo University Hospitals; Egypt ABSTRACT Background: Shunt Malfunction is still a challenging problem for neurosurgeons despite the advances in shunt technologies and techniques. Objective: The aim of this study is to evaluate efficacy, safety, and possible complications of endoscopic intervention in treating shunt malfunction. Methods: Retrospective study of prospectively collected date of 12 consecutive patients between January 2006 and December 2008 presenting with V-P shunt malfunction. 7 patients (58%) were operated upon by Endoscopic Third Ventriculostomy (ETV), 3 patients (25%) had shunt malposition and the shunts were redirected under endoscopic guidance, and 2 patients (17%) had endoscopic lysis of catheter tip adhesions and ETV. Results: Clinically, all patients (100%) had marked improvement of symptoms during the first postoperative week. Radiologically, 7 patients (58%) had reduced ventricular size, 12 patients (100%) had restoration of lax subarachnoid space, and 3 patients with shunt tip malposition showed good postoperative tip site. Complications were encountered in 3 patients (25%), 2 of them had postoperative ventriculitis and were treated by shunt removal and External Ventricular Drain (EVD) placement, while the third patient presented with shunt malfunction 9 months postoperative and had resurgery (ETV). No procedure related complications were reported. Conclusion: Endoscopic procedures in experienced hands are safe and effective alternatives in treating V-P shunt malfunction and malposition with high success rate and few reported complications. [Egypt J Neurol Psychiat Neurosurg. 2010; 47(3): ] Key Words: shunt malfunction, third ventriculostomy, septostomy. INTRODUCTION Shunt malfunction is still an existing problem for neurosurgeons and remains challenging despite the great progress in shunt technologies in the past decades. 1,2,3 Shunt dysfunction may be caused by several factors most commonly obstruction of the ventricular catheter by choroid plexus. 4 The repeated shunt malfunction after surgical revision provided a problem that led neurosurgeons to search alternative ways trying to avoid multiple shunt revisions which is associated with high incidence of complications like infection. 5 Since the early 1990s, fiberoptic endoscopes became available for use in treating shunt related problems providing a safe and effective tool to reach the ventricular catheter and handle the problem in cases of shunt malfunction as well as providing a guide for shunt placement. 6 Correspondence to Hazem Mostafa Kamal, Department of Neurosurgery, Cairo University, Egypt. Tel: zoomi73@hotmail.com Several endoscopic procedures had been postulated for dealing with shunt malfunction; ETV was reported to be an effective method in such cases with good outcome data. 7,8,9 In addition, the endoscope provides efficient visualization of the ventricular system allowing cauterization or lysis of choroid or ependymal adhesions that may partially obstruct the tip of the ventricular catheter, as well as repositioning of the catheter s tip in a proper site or passing it through a septostomy performed for unilateral ventricular dilatation. 6,10 The aim of this study is to evaluate the efficacy, safety, and possible complications with endoscopic procedures in treating different types of shunt malfunction. PATIENTS AND METHODS This study is a retrospective study of prospectively collected data of 12 patients admitted to Department of Neurosurgery, Cairo University Hospitals between January 2006 and December 2008 was done. Egypt J Neurol Psychiat Neurosurg. Jan 2010 Vol 47 Issue 1 367
2 Patient selection was based on; 1) all had posterior parietal V-P shunt placement for different causes of hydrocephalus, 2) all patients suffered shunt malfunction +/- malposition and had undergone shunt revision at least once with recurrence of symptoms, 3) all patients had CSF sampling via shunt tap, confirming them infection-free before endoscopic intervention. Patients included 5 males, 7 females (M:F ratio 1:1.4) with age ranging from 9 to 25 years (mean age 18 years). The time interval between shunt revision and endoscopic intervention ranged from 2-30 days (mean of 16 days). All patients were assessed clinically and radiologically by CT and/or MRI of the brain, in addition to abdominal CT scan excluding any causes of distal shunt malfunctiuon. Surgical Technique: All 12 patients were operated upon in Cairo University Hospitals by the author. Seven patients (58%) were operated upon by ETV alone without dealing with the ventricular catheter. Under general anesthesia, the patient was placed in a supine position with the head flexed A burr hole was created on the coronal suture, 3 cm off the midline. A rigid 0 endoscope lens (Karl Storz, Gaab System, Germany) was introduced through its sheath after ventricular cannulation. The floor of the 3 rd ventricle was reached via the foramen of Monro, fenestration of the floor between the infundibulum and mamillary bodies was performed using gentle blunt pressure by the diathermy probe and Fogarty balloon dilatation. The prepontine cistern is then inspected ensuring clear CSF pathway. Three patients (25%) were suffering from shunt malposition causing univentricular drainage. These patients were operated upon through a contralateral coronal burr hole performing septostomy by blunt and/or diathermy cauterization then the tip of the ventricular catheter was identified, grasped with a forceps and brought into the contralateral ventricle. Two patients (17%) were shown to have proximal shunt occlusion by choroid and ependymal tissues. These patients had endoscopic identification of the occluded catheter s tip, lysis of the obstructing tissues by diathermy coagulation and scissors until the catheter s tip is completely free. Then, ETV was performed to help in CSF drainage in case of recurrence of adhesions. RESULTS Demographic data of patients, cause of hydrocephalus, procedure and complications are illustrated in Table (1). Patients were assessed both clinically and radiologically with 2 nd day postoperative CT scans. Clinically, all 12 patients (100%) had marked improvement of symptoms of increased intracranial pressure within the first postoperative week. Radiologically, ventricular size, position of the ventricular catheter and laxity of the subarachnoid spaces were assessed as follows; 7 patients (58%) had reduction of the ventricular size as measured by the largest width of both frontal horns in postoperative CT scan. All patients (100%) showed laxity of the preoperative effaced subarachnoid spaces, while good shunt position was confirmed in the 3 patients having catheter repositioning through septostomy. Patients were followed up both clinically and radiologically in 3 months intervals for a period ranging from months (mean of 24 months). Two patients (17%) had recurrence of symptoms within 2 and 3 weeks postoperative, shunt tap and CSF analysis proved ventriculitis. Both patients had shunt removal and EVD placement for 7 days and 12 days respectively until CSF infection cleared then shunt placement was reperformed. One patient (8%) presented with recurrence of shunt malfunction 9 months after ETV, and was reoperated upon by endoscopic exploration showing adhesions partially obstructing the ostium of the 3 rd ventricle, endoscopic fenestration of the ostium was performed. No procedure-related complications were encountered. Figures (1) and (2) show illustrations of surgical procedures and neuroradiology of two of the patients included in the study. 368 Egypt J Neurol Psychiat Neurosurg. July 2010 Vol 47 Issue 3
3 Table 1. Demographic data, cause of hydrocephalus, procedure and complications of patients with Ventriculoperitoneal Shunt Malfunction and Malposition. Age (yrs) Sex Etiology of Hydrocephalus Interval between shunt revision and endoscopy Procedure Complications 1 10 M Vermian astrocytoma 30 days ETV None 2 15 M Aqueductal stenosis 20 days ETV Ventriculitis 3 22 F Aqueductal stenosis 4 days Septosomy, repositioning None 4 9 F 4 th ventricular medulloblastoma 7 days ETV Recurrence and resurgery 5 25 F Aqueductal stenosis 2 days ETV None 6 16 F Aqueductal stenosis 15 days ETV None 7 9 M 3 rd ventricular craniopharyngioma 24 days Septosomy, repositioning None 8 24 M Aqueductal stenosis 9 days Septosomy, repositioning None 9 21 F Aqueductal stenosis 18 days ETV Ventriculitis M Lateral ventricular ependymoma 25 days Lysis of adhesions, ETV None F Aqueductal stenosis 2 days ETV None F Tectal Glioma 14 days Lysis of adhesions, ETV None Figure 1. Case7: 9 yrs old male, preoperative CT (left) showing undrained left lateral ventricle, septostomy and repositioning of shunt (middle two), postoperative CT showing proper placement and drainage (right) Figure 2. Case 11: 22 yrs old female, preoperative CT (left) showing shunt malfunction, ETV performed (middle), postoperative CT showing proper ventricular drainage (right). Egypt J Neurol Psychiat Neurosurg. July 2010 Vol 47 Issue 3 369
4 DISCUSSION Despite the great advances in shunt technologies, shunt malfunction remains to be a challenging problem to neurosurgeons. 7 The risk of V-P shunt malfunction was reported to be 25-40% in the 1 st year and 4-5% per year thereafter. 1,11 Some authors postulated that 81% of shunts require revision after 12 years. 4 Many factors may cause shunt malfunction most commonly the position of the ventricular catheter and choroid plexus adhesions occurring around its tip. 12 Nowadays, the use of endoscopic techniques offered an excellent route for visualization of the ventricular system and the ventricular catheter facilitating management of shunt malfunction by various techniques. 13 Endoscopic 3 rd ventriculostomy (ETV) was reported to be an effective treatment in patients with obstructive hydrocephalus who had undergone previous shunt procedures. 14,15 High success rates were published by many authors ranging from %. Boschert and coworkers 7 in 2003 and Buxton et al. 16 in 2001 reported 82% success rate in 17 patients each. Murshid 17 in 2000 had 88.8% success rate in 9 patients while Cinalli and colleagues 18 in 1998 reported 76.7% success rate in 30 patients all with long term follow up. All reported no complications associated with ETV and failure was often attributed to ventriculitis. Other endoscopic procedures can be performed either alone or in combination with ETV, like lysis of adhesions around the ventricular catheter, fenestration of entrapped compartment, septostomy and shunt repositioning. 19 In our study, ETV, lysis of adhesions, repositioning of shunt through septostomy were performed with comparable success rate in 9 patients (75%) to the previously mentioned publications. No procedure related complications were encountered and failure was established in 3 patients (25%), 2 of them suffered from ventriculitis and the 3 rd had partial obliteration of the ETV 9 months later and the ostium was refenestrated. Failure rate was coinciding with published results in literature review as well as low rate of complications when performed by experienced hands. Conclusion Endoscopic procedures in experienced hands are safe and effective alternatives in treating V-P shunt malfunction and malposition with high success rate and few reported complications. [Disclosure: Author reports no conflict of interest] REFERENCES 1. Drake JM, Kestle J, Milner R, Cinalli G, Boop F, Piatt J Jr, et al. Randomized trial of cerebrospinal fluid shunt valve design in pediatric hydrocephalus. Neurosurgery. 1998; 43: Hoppe-Hirsch E, Laroussinie F, Brunet L, Sainte- Rose C, Renier D, Cinalli G, et al. Late outcome of the surgical treatment of hydrocephalus. Childs Nerv Syst. 1998; 14: Kestle J, Drake J, Milner R, Sainte-Rose C, Cinalli G, Boop F, et al. Long-term follow-up data from the Shunt Design Trial. Pediatr Neurosurg. 2000; 33: Sainte-Rose C, Piatt JH, Renier D, Pierre-Kahn A, Hirsch JF, Hoffmann HJ, et al. Mechanical complications in shunts. Pediatr Neurosurg. 1991; 17: Pettorini BL, Frassanito P, Tamburrini G, Massimi L, Caldarelli M, Di Rocco C. Retrieval of ventricular catheter with the aid of endoscopy. J Neurosurg pediatrics. 2008; 2: Walker ML, MacDonald J, Wright LC. The history of ventriculoscopy: where do we go from here?. Pediatr Neurosurg. 1992; 18: Boschert J, Hellwig D, Krauss JK. Endoscopic third ventriculostomy for shunt dysfunction in occlusive hydrocephalus: long-term follow up and review. J Neurosurg. 2003; 98: Cinalli G. Alternatives to shunting. Childs Nerv Syst. 1999; 15: Mallucci CL, Buxton N, Vloeberghs M, Punt J. Neuroendoscopic third ventriculostomy. the first line of treatment for blocked ventriculoperitoneal shunts? (Abstract). Eur J Pediatr Surg. 1997; 7 (Suppl 1): Schroeder HW, Oertel J, Gaab MR. Endoscopic treatment of cerebrospinal fluid pathway obstructions. Neurosurgery. 2007; 60 (2 Suppl): Piatt JH Jr, Carlson CV. A search for determinants of cerebrospinal fluid shunt survival: retrospective analysis of a 14-year institutional experience. Pediatr Neurosurg. 1993; 19: Tuli S, O Hayon B, Drake J, Clarke M, Kestle J. Change in ventricular size and effect of ventricular catheter placement in pediatric patients with shunted hydrocephalus. Neurosurgery. 1999; 45: Lewis AI, Keiper GL Jr, Crone KR. Endoscopic treatment of loculated hydrocephalus. J Neurosurg. 1995; 82: O Brien DF, Javadpour M, Collins DR, Spennato P, Mallucci CL. Endoscopic third ventriculostomy: an outcome analysis of primary cases and procedures performed after ventriculoperitoneal shunt malfunction. J Neurosurg. 2005; 103 (5 Suppl Pediatrics): Egypt J Neurol Psychiat Neurosurg. July 2010 Vol 47 Issue 3
5 15. Tisell M, Almstrom O, Stephensen H, Tullberg M, Wikkelso C. How effective is endoscopic third ventriculostomy in treating adult hydrocephalus caused by primary aqueductal stenosis?. Neurosurgery. 2000; 46: Buxton N, Ho KJ, Macarthur D, Vloeberghs M, Punt J, Robertson I. Neuroendoscopic third ventriculostomy for hydrocephalus in adults: report of a single unit s experience with 63 cases. Surg Neurol. 2001; 55: Murshid WR. Endoscopic third ventriculostomy: towards more indications for the treatment of non-communicating hydrocephalus. Minim Invasive Neurosurg. 2000; 43: Cinalli G, Salazar C, Mallucci C, Yada JZ, Zerah M, Sainte-Rose C. The role of endoscopic third ventriculostomy in the management of shunt malfunction. Neurosurgery. 1998; 43: Oi S, Abbott R. Loculated ventricles and isolated compartments in hydrocephalus: their pathophysiology and the efficacy of neuroendoscopic surgery. Neurosurg Clin N Am. 2004; 15: Schroeder HW, Niendorf WR, Gaab MR. Complications of endoscopic third ventriculostomy. J Neurosurg. 2002; 96: الملخص العربي أهمهاك ايساياي أن تغيار األعصاك تباييك لج اربا الما استسااك مرضا ةعا فا الةريتاني للصامكم المخا تمثل المشاكلل المصاكبة للصمكم نضع الاسطرة المخي 21 بكلاا لرهااك ماان خاا ل ي ارساا السااكة مشااكلل الصاامكمك لعاا ةااكلم الميظكرياا الج اربااك نتاياايم يتااك لي ارساا هاا ا الةباا يهااي الااكهرة خا ل الفتارة مان يياكير جكمعا لهام ةمستشافيك ميظكريا ج ارباك نتم إجا ار مختلف ألسةك صمكم الم يعكينن من خلل ةنظك مري ييسمةر نبت لتنصاايل الثكلاا ةااكلةطين المخاا )%82( تاام عماال ثااا : 7 بااك المرضاا لهااء الميظكرياا أيااناع ماان الج اربااك ث ثاا نقااي تاام إجاا ار ةاين الةطيياين الشافك ةكلبجاك عمل ثاا ( %18( تم إج ار لتيعيم عمل صمكم الم 3 بك الاكعي الصهكري إل الشنل السك ل المخ ماع الميظاكر الج اربا ةناساط الاسطرة المخي بنل طر فك التصكقك بين تم إج ار من خ له ف نتعييل نضع صمكم الم الجكيةيين ةكلم بكلتين )%27( ف الثكل ةكلةطين المخ عمل ثا )%82( 7 باك فا الما لةطيياك )%200( مع تبسن الشلل التشريب جميع المرض ف تبسن ملبنظ ةكألع ار اليتك نأظهر نتاام الشاانل ةكلسااك ل المخاا : أثيااين ماايهم أصاايةنا ةكلتهااك 3 بااك فاا مضااكعفك نقااي باايث 3 بااك فاا نتعاييل نضااع الاسااطرة المخياا األخيارة فااي أماك البكلا ا لتهاك علا جيياي ةعاي الاضاك ةريتاني صامكم مخا ماع إعاكية ترليا صامكم خاكرج ع جهام ةياعع الصامكم نترليا فا الميظكريا مةكشارة للج ارباك تنجاي مضاكعفك لع جاه ن أخار ميظكريا ج اربا من ارتجكع يسياي الصامكم ةعاي 9 شاهنر نتام إجا ار عكي. جميع البك معااايل ماااع قلااا الةريتاااني ايساااياي الصااامكم المخااا باااك عااا فااا الميظكريااا نأماااكن الج ارباااك فكعليااا تءلاااي ماااي هااا ا الةبااا يتاااك. المضكعفك Egypt J Neurol Psychiat Neurosurg. July 2010 Vol 47 Issue 3 371
Researcher 2018;10(3)
Comparative study between frontal and posterior parietal ventriculo-peritoneal shunts in management of hydrocephalus Prof. Dr. Abdelhalim Moasa, Dr. Mohamed Hasan and Mohamed Abdelrazek Department of Neurosurgery,
More informationEndoscopic Third Ventriculostomy in Patients with Shunt Malfunction
www.jkns.or.kr 10.3340/jkns.2011.49.4.217 J Korean Neurosurg Soc 49 : 217-221, 2011 Print ISSN 2005-3711 On-line ISSN 1598-7876 Copyright 2011 The Korean Neurosurgical Society Clinical Article Endoscopic
More informationClinical Study Endoscopic Third Ventriculostomy in Previously Shunted Children
Minimally Invasive Surgery Volume 2013, Article ID 584567, 4 pages http://dx.doi.org/10.1155/2013/584567 Clinical Study Endoscopic Third Ventriculostomy in Previously Shunted Children Eva Brichtova, 1
More informationOver the last few decades, endoscopic third ventriculostomy
clinical article J Neurosurg Pediatr 17:734 738, 2016 Long-term follow-up of endoscopic third ventriculostomy performed in the pediatric population Matthew G. Stovell, MBBS, 1 Rasheed Zakaria, MA, BMBCh,
More informationComplex Hydrocephalus
2012 Hydrocephalus Association Conference Washington, DC - June 27-July1, 2012 Complex Hydrocephalus Marion L. Walker, MD Professor of Neurosurgery & Pediatrics Primary Children s Medical Center University
More informationIn March of 2000, my family and I moved to Mbale,
CHPTER 13 Endoscopic Third Ventriculostomy and Choroid Plexus Cauterization for Pediatric Benjamin C. Warf, M.D. In March of 2, my family and I moved to Mbale, Uganda, to help Children s United Rehabilitation
More informationEndoscopic Third Ventriculostomy. Dr Kanwaljeet Garg
Endoscopic Third Ventriculostomy Dr Kanwaljeet Garg Introduction Endoscopic third ventriculostomyis a technique to treat non communicating hydrocephalus. Involves making a hole in the floor of the third
More informationThe role of endoscopic third ventriculostomy in the treatment of hydrocephalus
BRIEF COMMUNICATIONS ALBANIAN MEDICAL JOURNAL The role of endoscopic third ventriculostomy in the treatment of hydrocephalus Artur Xhumari 1,2, Ermira Pajaj 2, Maren Ruka 2, Mithat Demneri 2, Mentor Petrela
More informationDeath after late failure of third ventriculostomy in children
J Neurosurg 97:211 215, 2002 Death after late failure of third ventriculostomy in children Report of three cases WALTER J. HADER, M.D., F.R.C.S.(C), JAMES DRAKE, M.D., F.R.C.S.(C), DOUGLAS COCHRANE, M.D.,
More informationDelayed Posttraumatic Hydrocephalus Secondary To An Aqueductal Web Treated With Endoscopic Third Ventriculostomy: A Case Report.
ISPUB.COM The Internet Journal of Neurosurgery Volume 8 Number 1 Delayed Posttraumatic Hydrocephalus Secondary To An Aqueductal Web Treated With Endoscopic Third J Roth, S Rodgers, D Harter Citation J
More informationAnn Marie Flannery, M.D., 1 Ann-Christine Duhaime, M.D., 2 1
J Neurosurg Pediatrics (Suppl) 14:24 29, 2014 AANS, 2014 Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 3: Endoscopic computer-assisted electromagnetic navigation
More informationNature and Science 2017;15(7) Surgical Options for Treatment of Posterior Fossa Tumors with Hydrocephalus
Surgical Options for Treatment of Posterior Fossa Tumors with Hydrocephalus Mohamed Mahmoud Abohashima; Ahmed Mohamed Hasan Salem; Magdy Asaad El-Hawary Neurosurgery department, Faculty of Medicine, Al-azhar
More informationIntraventricular hemorrhage (IVH) in preterm infants
J Neurosurg Pediatrics 13:433 439, 2014 AANS, 2014 Endoscopic third ventriculostomy and choroid plexus cauterization in posthemorrhagic hydrocephalus of prematurity Clinical article Parthasarathi Chamiraju,
More informationEffect of Electromagnetic Navigated Ventriculoperitoneal Shunt Placement on Failure Rates
www.jkns.or.kr http://dx.doi.org/10.3340/jkns.2013.53.3.150 J Korean Neurosurg Soc 53 : 150-154, 2013 Print ISSN 2005-3711 On-line ISSN 1598-7876 Copyright 2013 The Korean Neurosurgical Society Clinical
More informationThe Egyptian Journal of Hospital Medicine (July 2018) Vol. 72 (9), Page
The Egyptian Journal of Hospital Medicine (July 2018) Vol. 72 (9), Page 5259-5269 Role of Neuroendoscopy in Management of Intraventricular Lesions Shehab Mohamed El Khadrawy, Mohamed Ahmed Ellabbad, Ahmed
More informationSelection of the appropriate surgical method CSF
J Neurosurg Pediatrics (Suppl) 14:30 34, 2014 AANS, 2014 Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 4: Cerebrospinal fluid shunt or endoscopic third ventriculostomy
More informationUC Davis Dermatology Online Journal
UC Davis Dermatology Online Journal Title Scalp necrosis overlying a ventriculoperitoneal shunt: a case report and literature review Permalink https://escholarship.org/uc/item/2rs544f9 Journal Dermatology
More informationNeural tube defects are common in East Africa relative
J Neurosurg Pediatrics 2:000 000, 2:310 316, 2008 Combined endoscopic third ventriculostomy and choroid plexus cauterization as primary treatment of hydrocephalus for infants with myelomeningocele: long-term
More informationLimitations of Neuroendoscopic Treatment for Pediatric Hydrocephalus and Considerations from Future Perspectives
REVIEW ARTICLE Neurol Med Chir (Tokyo) 55, 611 616, 2015 doi: 10.2176/nmc.ra.2014-0433 Online July 28, 2015 Limitations of Neuroendoscopic Treatment for Pediatric Hydrocephalus and Considerations from
More informationThe debate over ETV versus CSF shunting for the
See the corresponding editorial in this issue, pp 307 309. J Neurosurg Pediatrics 6:000 000, 6:310 315, 2010 Predicting who will benefit from endoscopic third ventriculostomy compared with shunt insertion
More informationThe Hydrocephalus Clinical Research Network
J Neurosurg Pediatrics 14:173 178, 2014 AA, 2014 Factors associated with ventricular catheter movement and inaccurate catheter location: post hoc analysis of the Hydrocephalus Clinical Research Network
More informationAn approach using the occipital parietal point for placement of ventriculoperitoneal catheters in adults. Abstract Introduction Methods Results
An approach using the occipital parietal point for placement of ventriculoperitoneal catheters in adults. Jason Duong, DO 1, Dan Miulli DO 1, Fanglong Dong, PhD 2, Andrew Sumida MSIV 3, 1 Neurosurgery
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 3,900 116,000 120M Open access books available International authors and editors Downloads Our
More informationHydrocephalus remains a major contributor to the
PEDIATRICS clinical article J Neurosurg Pediatr 15:524 528, 2015 Early outcome of combined endoscopic third ventriculostomy and choroid plexus cauterization in childhood hydrocephalus Olufemi B. Bankole,
More informationCombined endoscopic third ventriculostomy and tumor biopsy in the management of pineal region tumors, safety considerations
Amer and Elatrozy Egyptian Journal of Neurosurgery (2018) 33:23 https://doi.org/10.1186/s41984-018-0022-7 Egyptian Journal of Neurosurgery RESEARCH Open Access Combined endoscopic third ventriculostomy
More informationNeurosurgery Department, Cork University Hospital, Cork, Republic of Ireland
J Neurosurg 103:848 852, 2005 Use of a simple intraoperative hydrostatic pressure test to assess the relationship between mobility of the ventricular stoma and success of third ventriculostomy MAHMOUD
More informationNovel adaptation of the AxiEM electromagnetic neuronavigation system for intraoperative tracking of neuroendoscope during intraventricular surgery
www.edoriumjournals.com CASE SERIES PEER REVIEWED OPEN ACCESS Novel adaptation of the AxiEM electromagnetic neuronavigation system for intraoperative tracking of neuroendoscope during intraventricular
More informationSurgery for hydrocephalus in sub-saharan Africa versus developed nations: a risk-adjusted comparison of outcome
Childs Nerv Syst (2010) 26:1711 1717 DOI 10.1007/s00381-010-1195-x ORIGINAL PAPER Surgery for hydrocephalus in sub-saharan Africa versus developed nations: a risk-adjusted comparison of outcome Abhaya
More informationOA Ojo 1, OB Bankole 1, OO Kanu 1, NU Okubadejo 2
Original Article Efficacy of endoscopic third ventriculostomy in the management of hydrocephalus in children under 2 years of age: Experience from a tertiary institution in Nigeria OA Ojo 1, OB Bankole
More informationCURE Children s Hospital of Uganda, Mbale, Republic of Uganda
J Neurosurg (6 Suppl Pediatrics) 103:475 481, 2005 Comparison of endoscopic third ventriculostomy alone and combined with choroid plexus cauterization in infants younger than 1 year of age: a prospective
More informationVentricular catheter entry site and not catheter tip location predicts shunt survival: a secondary analysis of 3 large pediatric hydrocephalus studies
Clinical article J Neurosurg Pediatr 19:157 167, 2017 Ventricular catheter entry site and not catheter tip location predicts shunt survival: a secondary analysis of 3 large pediatric hydrocephalus studies
More informationEndoscopic third ventriculostomy (ETV) is considered
clinical article J Neurosurg 124:1413 1420, 2016 Lower rates of symptom recurrence and surgical revision after primary compared with secondary endoscopic third ventriculostomy for obstructive hydrocephalus
More informationMicrosurgical third ventriculocisternostomy as an alternative to ETV: report of two cases
Childs Nerv Syst (2008) 24:757 761 DOI 10.1007/s00381-007-0572-6 CASE REPORT Microsurgical third ventriculocisternostomy as an alternative to ETV: report of two cases Erik J. van Lindert Received: 10 August
More informationEndoscopic third ventriculostomy versus ventriculoperitoneal shunt in the treatment of obstructive hydrocephalus in children
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 79-85, p-issn: 79-861.Volume 16, Issue 1 Ver. IX (Dec. 17), PP 7-5 www.iosrjournals.org Endoscopic third ventriculostomy versus ventriculoperitoneal
More informationThe use of endoscopy in the treatment of hydrocephalus. Endoscopic options in children: experience with 134 procedures.
J J Neurosurg Pediatrics 3:000 000, 3:81 89, 2009 Endoscopic options in children: experience with 134 procedures Clinical article Jo a c h i m M. K. Oe r t e l, M.D., Ph.D., 1 Jo e r g Ba l d a u f, M.D.,
More informationVentriculo-Peritoneal/ Lumbo-Peritoneal Shunts
Ventriculo-Peritoneal/ Lumbo-Peritoneal Shunts Exceptional healthcare, personally delivered Ventriculo-Peritoneal/ Lumbo-Peritoneal Shunts What is hydrocephalus? Hydrocephalus is the build up of an excess
More informationRisk factors for Ventriculoperitoneal shunting in children with posterior fossa tumor
Risk factors for Ventriculoperitoneal shunting in children with posterior fossa tumor Raed M Aljubour, MD *, Ahmed K Alomari, MD*, Awni F Musharbash, MD** ABSTRACT Objectives: To investigate the Predictors
More informationSee the corresponding editorial in this issue, pp J Neurosurg Pediatrics 14: , 2014 AANS, 2014
See the corresponding editorial in this issue, pp 221 223. J Neurosurg Pediatrics 14:224 229, 2014 AANS, 2014 Endoscopic third ventriculostomy and choroid plexus cauterization in infants with hydrocephalus:
More informationUnfortunately, shunt malfunction is one of the
J Neurosurg Pediatrics 14:160 166, 2014 AANS, 2014 Utility of computed tomography or magnetic resonance imaging evaluation of ventricular morphology in suspected cerebrospinal fluid shunt malfunction Clinical
More informationTh e value of being able to predict the likely success
J Neurosurg Pediatrics 5:000 000, 5:204 209, 2010 Intraoperative assessment of cerebral aqueduct patency and cisternal scarring: impact on success of endoscopic third ventriculostomy in 403 African children
More informationArachnoid cysts account for 1% of all intracranial. Endoscopic treatment of intraparenchymal arachnoid cysts in children.
J Neurosurg Pediatrics 14:501 507, 2014 AANS, 2014 Endoscopic treatment of intraparenchymal arachnoid cysts in children Clinical article Nasser M. F. El-Ghandour, M.D. Department of Neurosurgery, Faculty
More informationRESEARCH ARTICLE RELATIVE FREQUENCY OF HYDROCEPHALUS IN RASHT PEDIATRIC PATIENTS
RESEARCH ARTICLE RELATIVE FREQUENCY OF HYDROCEPHALUS IN RASHT PEDIATRIC PATIENTS Elham BIDABADI MD Assistant Professor of Pediatric Neurology, Guilan University of Medical Sciences,Guilan,Iran Corresponding
More informationGEORGE E. PERRET, M.D., AND CARL J. GRAF, M.D.
J Neurosurg 47:590-595, 1977 Subgaleal shunt for temporary ventricle decompression and subdural drainage GEORGE E. PERRET, M.D., AND CARL J. GRAF, M.D. Division of Neurological Surgery, University of Iowa
More informationRadiological evaluation of ventriculoperitoneal shunt systems
Radiological evaluation of ventriculoperitoneal shunt systems Poster No.: C-702 Congress: ECR 2009 Type: Educational Exhibit Topic: Neuro Authors: T. Rodt, C. von Falck, C. Tschan, M. Diensthuber, J. Zajaczek,
More informationFlexible endoscopy for management of intraventricular brain tumors in patients with small ventricles
J Neurosurg Pediatrics 14:490 494, 2014 AANS, 2014 Flexible endoscopy for management of intraventricular brain tumors in patients with small ventricles Clinical article Hideki Ogiwara, M.D., Ph.D., and
More informationLong-term outcomes of endoscopic third ventriculostomy in adults
Waqar et al. Long-term outcomes of endoscopic third ventriculostomy in adults Running title: Long-term ETV outcomes in adults Word count: 2990 Submission category: Clinical article Authors and affiliations
More informationTransventricular Biopsy of Brain Tumor without Hydrocephalus Using Neuroendoscopy with Navigation
www.jkns.or.kr 10.3340/jkns.2010.47.6.415 J Korean Neurosurg Soc 47 : 415-419, 2010 Print ISSN 2005-3711 On-line ISSN 1598-7876 Copyright 2010 The Korean Neurosurgical Society Clinical Article Transventricular
More informationPlacement and revision of ventricular shunts for hydrocephalus
J Neurosurg 120:684 696, 2014 AANS, 2014 Improvement in clinical outcomes following optimal targeting of brain ventricular catheters with intraoperative imaging Clinical article Christopher G. Janson,
More informationObjective Since its revival in the early 1990s, neuroendoscopy has become an integral component of modern neurosurgery.
clinical article J Neurosurg 125:576 584, 2016 Neuroendoscopic stent for cerebrospinal fluid pathway obstructions in adults Sascha Marx, MD, 1 Steffen K. Fleck, MD, 1 Ehab El Refaee, MD, 1,2 Jotham Manwaring,
More informationEndoscopy in the treatment of slit ventricle syndrome
EXPERIMENTAL AND THERAPEUTIC MEDICINE 14: 3381-3386, 2017 Endoscopy in the treatment of slit ventricle syndrome JIAPING ZHENG, GUOQIANG CHEN, QING XIAO, YIYANG HUANG and YUPENG GUO Department of Neurosurgery,
More informationThe second most common reason for being sued for negligence in neurosurgery is a problem
Correspondence to: Mr Ian K Pople, Department of Neurosurgery, Frenchay Hospital, Frenchay Park Road, Bristol BS16 1LE, UK: ikpople@hotmail.com HYDROCEPHALUS AND SHUNTS: WHAT THE NEUROLOGIST SHOULD KNOW
More informationLong-term outcomes in patients with treated childhood hydrocephalus
See the corresponding editorial in this issue, p 333. J Neurosurg (5 Suppl Pediatrics) 106:334 339, 2007 Long-term outcomes in patients with treated childhood hydrocephalus NALIN GUPTA, M.D., PH.D., 1,2
More informationSuprasellar Arachnoid Cysts. Wan Tew SEOW FRACS Singapore
Suprasellar Arachnoid Cysts Wan Tew SEOW FRACS Singapore Distribution Intracranial Arachnoid Cysts Sylvian fissure 49% CPA 11% Quadrigeminal 10% Vermian 9% Sellar and suprasellar 9% Interhemispheric 5%
More informationAt presentation, children with posterior fossa tumors
Clinical article J Neurosurg Pediatr 18:21 28, 2016 Childhood hydrocephalus secondary to posterior fossa tumor is both an intra- and extraaxial process Grant A. Bateman, MBBS, MD, FRANZCR, 1,2 and Mark
More informationAlthough neuroendoscopy was originally devised. Small-ventricle neuroendoscopy for pediatric brain tumor management.
J Neurosurg Pediatrics 7:000 000, 7:104 110, 2011 Small-ventricle neuroendoscopy for pediatric brain tumor management Clinical article Robert P. Naftel, M.D., 1 Chevis N. Shannon, M.B.A., M.P.H., Dr.P.H.,
More informationSpontaneous Ventriculostomy: Report of Three Cases Revealed by Flow-Sensitive Phase-Contrast Cine MR Imaging
AJNR Am J Neuroradiol 20:1647 1652, October 1999 Case Report Spontaneous Ventriculostomy: Report of Three Cases Revealed by Flow-Sensitive Phase-Contrast Cine MR Imaging Alex Rovira, Jaume Capellades,
More informationViscus Perforation in Children caused by Peritoneal Shunt Catheters : Case series of 10 patients and review of literature
Viscus Perforation in Children caused by Peritoneal Shunt Catheters : Case series of 10 patients and review of literature Mohamad Bakhaidar Division of Neurological Surgery, Faculty of Medicine, King Abdulaziz
More informationThe "Keyhole": A Sign of
473 The "Keyhole": A Sign of Herniation of a Trapped Fourth Ventricle and Other Posterior Fossa Cysts Barbara J. Wolfson' Eric N. Faerber' Raymond C. Truex, Jr. 2 When a cystic structure in the posterior
More informationThe arrest of treated hydrocephalus in children
J Neurosurg 61:752-756, 1984 The arrest of treated hydrocephalus in children A radionuclide study IAN H. JOHNSTON, F.R.C.S., ROBERT HOWMAN-GILES, F.R.A.C.P., AND IAN R. WHITTLE, M.B., B.S. T. Y. Nelson
More informationResidence of Discipline of Neurosurgery of Hospital da Santa Casa de Misericórdia of Sao Paulo Sao Paulo, Brazil
Cronicon OPEN ACCESS NEUROLOGY Research Article Efficacy of the Lamina Terminalis Fenestration Associated With the Liliequist Membrane Fenestration in Reducing Shunt-Dependent Hydrocephalus Following Aneurysm
More informationEndoscopic third ventriculostomy for hydrocephalus: A review of indications, outcomes, and complications
[Downloaded free from http://www.neurologyindia.com on Thursday, November 15, 2012, IP: 111.93.134.186] Click here to download free Android application for t Topic of the issue: Review Article Endoscopic
More informationPerioperative Management Of Extra-Ventricular Drains (EVD)
Perioperative Management Of Extra-Ventricular Drains (EVD) Dr. Vijay Tarnal MBBS, FRCA Clinical Assistant Professor Division of Neuroanesthesiology Division of Head & Neck Anesthesiology Michigan Medicine
More informationA multicenter prospective cohort study of the Strata valve for the management of hydrocephalus in pediatric patients
J Neurosurg (Pediatries 2) 102:141-145, 2005 A multicenter prospective cohort study of the Strata valve for the management of hydrocephalus in pediatric patients J ohn R. W. K kstlk, M.D., M ario n L.
More informationMark R. Kraemer, MD, Carolina Sandoval-Garcia, MD, Taryn Bragg, MD, and Bermans J. Iskandar, MD
CLINICAL ARTICLE J Neurosurg Pediatr 20:216 224, 2017 Shunt-dependent hydrocephalus: management style among members of the American Society of Pediatric Neurosurgeons Mark R. Kraemer, MD, Carolina Sandoval-Garcia,
More informationHIROSHI NAKAGUCHI, M.D., PH.D., TAKEO TANISHIMA, M.D., PH.D., Clinical Material and Methods
J Neurosurg 93:791 795, 2000 Relationship between drainage catheter location and postoperative recurrence of chronic subdural hematoma after burr-hole irrigation and closed-system drainage HIROSHI NAKAGUCHI,
More informationEndoscopic Surgery for Third Ventricular Colloid Cysts in the Absence of Hydrocephalus: a feasibility study
Commentary Endoscopic Surgery for Third Ventricular Colloid Cysts in the Absence of Hydrocephalus: a feasibility study Guive Sharifi, Mehrdad Hosseinzadeh Bakhtevari, Omidvar Rezaei, Reza Jabbari Department
More informationMultiple Intracranial High Density Foci after Brain Parenchymal Catheterization
CLINICL RTICLE Korean J Neurotrauma 2016;12(2):118-122 pissn 2234-8999 / eissn 2288-2243 https://doi.org/10.13004/kjnt.2016.12.2.118 Multiple Intracranial High Density Foci after rain Parenchymal Catheterization
More informationDandy-Walker syndrome: different modalities of treatment and outcome in 42 cases
Child s Nerv Syst (2001) 17:348 352 DOI 10.1007/s003810000425 ORIGINAL PAPER Raj Kumar Manoj Kumar Jain Devendra Kumar Chhabra Dandy-Walker syndrome: different modalities of treatment and outcome in 42
More informationClinical Study The Value of Programmable Shunt Valves for the Management of Subdural Collections in Patients with Hydrocephalus
The Scientific World Journal Volume 2013, Article ID 461896, 4 pages http://dx.doi.org/10.1155/2013/461896 Clinical Study The Value of Programmable Shunt Valves for the Management of Subdural Collections
More informationBetween one-quarter and one-third of patients with a
CLINICAL ARTICLE J Neurosurg Pediatr 19:578 584, 2017 The durability of endoscopic third ventriculostomy and ventriculoperitoneal shunts in children with hydrocephalus following posterior fossa tumor resection:
More informationNEUROSURGEON VS. HOSPITALIST Pediatric Hospital Medicine meeting Nashville, TN July 21, 2017*±
NEUROSURGEON VS. HOSPITALIST Pediatric Hospital Medicine meeting Nashville, TN July 21, 2017*± *no pediatricians were harmed in the making of this presentation ±nonetheless, please do not try this at home
More informationAnesthetic Management of Laparoscopic Surgery for a Patient with
Anesthetic Management of Laparoscopic Surgery for a Patient with a Ventriculoperitoneal shunt Abstract With the advances in the management of hydrocephalus, patients with ventriculoperitoneal shunt are
More informationEndoscopic Management of Intraventricular Neurocysticercosis
DOI: 10.5137/1019-5149.JTN.21389-17.3 Received: 07.08.2017 / Accepted: 22.01.2018 Published Online: 21.02.2018 Turk Neurosurg, 2018 Original Investigation Endoscopic Management of Intraventricular Neurocysticercosis
More informationOriginal Article. Emergency Department Evaluation of Ventricular Shunt Malfunction. Is the Shunt Series Really Necessary? Raymond Pitetti, MD, MPH
Original Article Emergency Department Evaluation of Ventricular Shunt Malfunction Is the Shunt Series Really Necessary? Raymond Pitetti, MD, MPH Objective: The malfunction of a ventricular shunt is one
More informationWi t h an annual population incidence for shunt. Navigated endoscopic surgery for multiloculated. hydrocephalus in children.
J Neurosurg Pediatrics 5:000 000, 5:434 442, 2010 Navigated endoscopic surgery for multiloculated hydrocephalus in children Clinical article Ma t t h i a s Sc h u l z, M.D., 1 Ge o r g Bo h n e r, M.D.,
More informationWe are IntechOpen, the first native scientific publisher of Open Access books. International authors and editors. Our authors are among the TOP 1%
We are IntechOpen, the first native scientific publisher of Open Access books 3,350 108,000 1.7 M Open access books available International authors and editors Downloads Our authors are among the 151 Countries
More informationSpinal Cord Gliomas and Hydrocephalus: Utility of Neuroendoscopy
M. Galarza 1 P. Peretta 1 R. Gazzeri 4 G. Cinalli 1 M. Forni 2 I. Morra 2 P. Ragazzi 1 S. Sandri 3 Spinal Cord Gliomas and Hydrocephalus: Utility of Neuroendoscopy Abstract Objective: The aim of this study
More informationIntroduction to Neurosurgical Subspecialties:
Introduction to Neurosurgical Subspecialties: Pediatric Neurosurgery Brian L. Hoh, MD 1 and Gregory J. Zipfel, MD 2 1 University of Florida, 2 Washington University Pediatric Neurosurgery Pediatric neurosurgeons
More informationPeng Zhao 1, Xinsheng Wang 1, Chuzhong Li 2, Songbai Gui 1, Xuyi Zong 1 and Yazhuo Zhang 2*
Zhao et al. BMC Neurology 2013, 13:59 RESEARCH ARTICLE Open Access The effectiveness of neuroendoscopic versus non-neuroendoscopic procedures in the treatment of lateral ventricular cysts: a retrospective
More informationParkinsonism after Shunting for Hydrocephalus Secondary to Aqueductal Stenosis with Chiari Malformation
ISPUB.COM The Internet Journal of Neurosurgery Volume 6 Number 2 Parkinsonism after Shunting for Hydrocephalus Secondary to Aqueductal Stenosis with Chiari M Turgut Citation M Turgut. Parkinsonism after
More informationAccuracy of the Free Hand Placement of an External Ventricular Drain (EVD)
KOR J CEREBROVASCULAR SURGERY June 2O10 Vol. 12 No 2, page 82-6 Accuracy of the Free Hand Placement of an External Ventricular Drain (EVD) Department of Neurosurgery, Gachon University of Medicine & Science,
More informationAnatomy, Terminology and Treatment in Pediatric Neurosurgery Part I
Anatomy, Terminology and Treatment in Pediatric Neurosurgery Part I John Ragheb, MD, FACS, FAAP Professor of Neurosurgery and Pediatrics, Affiliated Faculty of University of Miami, Miller School of Medicine
More informationVentriculoperitoneal shunt infection in Haji Adam Malik Hospital, Medan
Ventriculoperitoneal shunt infection in Haji Adam Malik Hospital, Medan R Dharmajaya Head department of neurosurgery, faculty medicine of Sumatera Utara University E-mail: Abstract.Ventriculoperitoneal
More informationINTRACRANIAL ARACHNOID CYSTS: CLASSIFICATION AND MANAGEMENT. G. Tamburrini, Rome
INTRACRANIAL ARACHNOID CYSTS: CLASSIFICATION AND MANAGEMENT G. Tamburrini, Rome Incidence 2% of occasional neuroradiological findings From clinical studies (1960 s): 0.4-1% of intracranial space occupying
More informationOriginal Article Clinical Outcome after Transcortical Approach for Lateral Ventricular Neoplasms
Egyptian Journal of Neurosurgery Volume 29 / No. 2 / April - June 2014 19-24 Original Article Clinical Outcome after Transcortical Approach for Lateral Ventricular Neoplasms ARTICLE INFO Received: 1 March
More informationNeuroscience Chair CEU-NISA CEU Universidad Cardenal Herrera Valencia Spain
Neurosurgery, Education and Development (NED) Foundation: Global Health and Humanitarian Neurosurgery. J. Piquer; JL Llacer; P. Riesgo; V Rovira; R. Rodríguez; MP. Chisbert; L. Moreno, MS. Girbes Neuroscience
More informationSurgical management of the fourth ventricle arachnoid cysts
Annals of Medical Research DOI: 10.5455/annalsmedres.2018.09.199 2019;26(1):42-6 Original Article Surgical management of the fourth ventricle arachnoid cysts Sukru Oral 1, Hanifi Bayarogullari 2, Atilla
More informationInfantile Hydrocephalus: Remarks about the So-Called Unsuccessful Cases
Original Paper DOI: 1.1159/324913 Received: October 13, 1 Accepted after revision: February 2, 11 P u b l i s h e d o n l i n e : $ $ $ Endoscopic Third Ve nt riculostomy in O bst ruc t ive Infantile Hydrocephalus:
More informationPeri-operative risk factors for short-term revision in adult hydrocephalus patients
Peri-operative risk factors for short-term revision in adult hydrocephalus patients Dan Farahmand, Halfdan Hilmarsson, Mats Högfeldt, Magnus Tisell To cite this version: Dan Farahmand, Halfdan Hilmarsson,
More informationConversion technique from neuroendoscopy to microsurgery in ventricular tumors: Technical note
SNI: Neurobiology, a supplement to Surgical Neurology International OPEN ACCESS For entire Editorial Board visit : http://www.surgicalneurologyint.com Editor: James I. Ausman, MD, PhD University of California,
More informationOccult Cerebrospinal Fluid Fistula between Ventricle and Extra-Ventricular Position of the Ventriculoperitoneal Shunt Tip
197 Occult Cerebrospinal Fluid Fistula between Ventricle and Extra-Ventricular Position of the Ventriculoperitoneal Shunt Tip Ching-Yi Lee 1, Chieh-Tsai Wu 1, Kuang-Lin Lin 2, Hsun-Hui Hsu 3 Abstract-
More informationEvaluation of Shunt Malfunction Using Shunt Site Reservoir
Original Paper Pediatr Neurosurg 2000;32:180 186 Received: January 27, 1999 Accepted: April 27, 2000 Evaluation of Shunt Malfunction Using Shunt Site Reservoir S. Sood A.I. Canady Steven D. Ham Section
More informationCODING SHEET HYDROCEPHALUS REIMBURSEMENT. All Medicare information is current as of the time of printing.
CODING SHEET HYDROCEPHALUS REIMBURSEMENT All Medicare information is current as of the January 2014 Hydrocephalus ing Coding Options Commonly Billed Codes for Physicians, Hospitals, and Ambulatory Surgery
More informationExternal ventricular drain (EVD) placement for cerebrospinal. FOCUS Neurosurg Focus 43 (5):E5, 2017
NEUROSURGICAL FOCUS Neurosurg Focus 43 (5):E5, 2017 Real-time ultrasound-guided external ventricular drain placement: technical note James H. Manfield, MBBS, MSc, MRCS, 1 and Kenny K. H. Yu, MBBS, MRCS,
More informationInfusion studies in clinical practice. Kristian Aquilina Consultant paediatric neurosurgeon Great Ormond Street Hospital London
Infusion studies in clinical practice Kristian Aquilina Consultant paediatric neurosurgeon Great Ormond Street Hospital London 10 th September 2018 infusion study + hydrocephalus 216 publications Clinical
More informationClinical Outcome of Posterior Fossa Tumor Surgery Without Preoperative Ventriculo-peritoneal Shunt
Bangladesh Medical Journal 2011 Vol. 0 No. 1 Orginal Article Clinical Outcome of Posterior Fossa Tumor Surgery Without Preoperative Ventriculo-peritoneal Shunt MR Islam 1, KMT Islam 2, M Hossain, MH Rashid,
More informationShunt malfunction and Slight edema surrounding the ventricles: Ten case series
ISSN: 47-5 Volume Number 8 (August-04) pp. 4-45 www.ijcrar.com Shunt malfunction and Slight edema surrounding the ventricles: Ten case series Firooz Salehpoor, Arastoo Pezeshki, Amirhossein Haghir *, Aidin
More informationThe misplacement of external ventricular drain by freehand method in emergent neurosurgery
Acta Neurol. Belg., 2011, 111, 22-28 Original articles The misplacement of external ventricular drain by freehand method in emergent neurosurgery Cheng-Ta HsieH 1,2, Guann-Juh CHen 1, Hsin-i Ma 1, Cheng-Fu
More informationEndoscopic biopsy of intraventricular tumors in children
J Neurosurg Pediatrics 5:000 000, 5:255 262, 2010 Endoscopic biopsy of brain tumors in children: diagnostic success and utility in guiding treatment strategies Clinical article Ed w a r d S. Ahn, M.D.,
More informationHydrocephalus is extremely common in the developing
J Neurosurg Pediatrics 13:140 144, 2014 AANS, 2014 Effectiveness of the Bactiseal Universal Shunt for reducing shunt infection in a sub-saharan African context: a retrospective cohort study in 160 Ugandan
More information