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Bermans J Iskandar - One of the best experts on this subject based on the ideXlab platform.

  • reversible severe brainstem herniation and obstructive hydrocephalus from cystoperitoneal shunt overdrainage
    World Neurosurgery, 2019
    Co-Authors: Joyce Koueik, Sarah Kawtharani, Bermans J Iskandar
    Abstract:

    We present a case of symptomatic intracranial hypotension secondary to CSF overdrainage from a cystoperitoneal shunt system. Brain MRI shows distortion of the midbrain with secondary occlusion of the Cerebral Aqueduct resulting in obstructive hydrocephalus. The symptoms, brainstem herniation, and hydrocephalus resolved after tie occlusion of the shunt.

  • Endoscopically-assisted resection of a choroid plexus vascular malformation traversing the Cerebral Aqueduct: technical case report.
    Neurosurgery, 2006
    Co-Authors: Roham Moftakhar, M. Shahriar Salamat, Soner Sahin, Bermans J Iskandar
    Abstract:

    OBJECTIVE: We report a case of a choroid plexus vascular malformation of the Cerebral Aqueduct, third, and fourth ventricles of an adolescent female that was resected with endoscopic assistance. CLINICAL PRESENTATION: A 14-year-old girl presented with a 1-week history of headaches and emesis. A noncontrasted computed tomographic scan of the head demonstrated enlarged lateral and third ventricles. Subsequent magnetic resonance imaging scans with and without contrast revealed an enhancing mass originating in the third ventricle, traversing the Cerebral Aqueduct, and terminating in the fourth ventricle. RESULTS: We used a suboccipital approach to remove the vascular malformation after endoscopically disconnecting it from its feeding and draining vessels in the third ventricle. Total excision was performed. Postoperative magnetic resonance imaging scans and arteriograms confirmed complete resection of the vascular malformation. CONCLUSION: Choroid plexus vascular malformations can exist intraventricularly and can be confused with a neoplasm. Resection of these intraventricular lesions can be performed with endoscopic assistance.

  • Endoscopically-assisted resection of a choroid plexus vascular malformation traversing the Cerebral Aqueduct: technical case report.
    Neurosurgery, 2006
    Co-Authors: Roham Moftakhar, M. Shahriar Salamat, Soner Sahin, Bermans J Iskandar
    Abstract:

    We report a case of a choroid plexus vascular malformation of the Cerebral Aqueduct, third, and fourth ventricles of an adolescent female that was resected with endoscopic assistance. A 14-year-old girl presented with a 1-week history of headaches and emesis. A noncontrasted computed tomographic scan of the head demonstrated enlarged lateral and third ventricles. Subsequent magnetic resonance imaging scans with and without contrast revealed an enhancing mass originating in the third ventricle, traversing the Cerebral Aqueduct, and terminating in the fourth ventricle. We used a suboccipital approach to remove the vascular malformation after endoscopically disconnecting it from its feeding and draining vessels in the third ventricle. Total excision was performed. Postoperative magnetic resonance imaging scans and arteriograms confirmed complete resection of the vascular malformation. Choroid plexus vascular malformations can exist intraventricularly and can be confused with a neoplasm. Resection of these intraventricular lesions can be performed with endoscopic assistance.

Giuseppe Cinalli - One of the best experts on this subject based on the ideXlab platform.

  • Endoscopic anatomy of the Cerebral Aqueduct. Commentary
    Neurosurgery, 2007
    Co-Authors: Pierluigi Longatti, Alessandro Fiorindi, Alessandro Perin, Andrea Martinuzzi, James M. Drake, Guilherme Carvalhal Ribas, Michael R. Gaab, Mark M. Souweidane, Giuseppe Cinalli
    Abstract:

    OBJECTIVE: What is known about the Cerebral Aqueduct is derived mainly from the legacy of classic histology and from the most recent advanced neuroimaging technologies. In fact, although this important structure is frequently glimpsed by neurosurgeons, only limited anatomic contributions have been added by microsurgery to its direct in vivo description. A review of our surgical experience in navigating the fourth ventricle prompted us to revisit the classical anatomic descriptions of the Aqueduct and compare them using the novel perspective of neuroendoscopy. METHODS: We reviewed video recordings of 65 transAqueductal explorations of the fourth ventricle using flexible endoscopes, which were performed in our center to treat various pathological conditions. Forty-one patients were selected as being more informative for anatomic description. They include 21 patients with communicating normal pressure hydrocephalus, 6 patients with intraventricular hemorrhage, 5 patients with membranous obstruction of the foramen of Magendie, 5 patients with trapped fourth ventricle as evidenced after Aqueductoplasty, 3 patients with colloid cysts, and 1 patient with craniopharyngioma with apparently normal Aqueduct, which was navigated to aspirate small fragments of colloid and tiny clots. RESULTS: Patients with normal-sized third ventricles confirmed the typical triangular shape of the Aqueductal adytum, whereas all pathological Aqueducts invariably had an oval contour. The posterior commissure, a faint trace of the median sulcus, and the rubral eminences were the structures invariably noticed. Five segments of the Aqueduct were always identifiable: the adytum, first constriction, ampulla, second constriction, and posterior part or egressus. CONCLUSION: Neuroendoscopy provides a novel perspective into the inner Aqueductal wall and supplies an incomparable view of the intracanalicular anatomic structures.

  • endoscopic Aqueductoplasty and placement of a stent in the Cerebral Aqueduct in the management of isolated fourth ventricle in children
    Journal of Neurosurgery, 2006
    Co-Authors: Giuseppe Cinalli, Pietro Spennato, Luciano Savarese, Claudio Ruggiero, Ferdinando Aliberti, Lorenzo Cuomo, Emilio Cianciulli, Giuseppe Maggi
    Abstract:

    Object. In this study the authors conducted a retrospective evaluation of the effectiveness of endoscopic Aqueductoplasty, performed alone or accompanied by placement of a stent, in the treatment of an isolated fourth ventricle (IFV) in seven patients afflicted with loculated hydrocephalus after a hemorrhage or infection. Methods. Seven children with symptomatic IFV and membranous Aqueductal stenosis underwent endoscopic Aqueductoplasty alone or combined with placement of a stent in the Cerebral Aqueduct. The mean age of the patients at the time of surgery was 10 months. The mean duration of follow up was 26 months. In all patients a supratentorial shunt had already been implanted, and in five patients neuroendoscopy had already been performed because other isolated compartments had been present inside the ventricular system. Aqueductoplasty alone was performed in three patients and Aqueductoplasty and Aqueductal stent placement in four. A precoronal approach was performed in five patients and a suboccipital approach in two. Signs and symptoms of intracranial hypertension resolved in all cases. Stent placement was successful in all five cases, resulting in clinical and neuroimaging-confirmed improvements in the IFV. Restenosis of the Aqueduct occurred in two patients in whom stents had not been placed. In one of these patients restenosis was managed by an endoscopic procedure, during which the Aqueduct was reopened and a stent implanted; in the other patient a shunt was placed in the fourth ventricle. Hydrocephalus was controlled by a single shunt in six cases (86%) and by a double shunt in one case. Conclusions. Endoscopic placement of a stent in the Aqueduct is more effective in preventing the repeated occlusion of the Aqueduct than Aqueductoplasty alone and should be indicated as the initial treatment in each case of compatible anatomy.

  • Endoscopic Aqueductoplasty and placement of a stent in the Cerebral Aqueduct in the management of isolated fourth ventricle in children.
    Journal of neurosurgery, 2006
    Co-Authors: Giuseppe Cinalli, Pietro Spennato, Luciano Savarese, Claudio Ruggiero, Ferdinando Aliberti, Lorenzo Cuomo, Emilio Cianciulli, Giuseppe Maggi
    Abstract:

    In this study the authors conducted a retrospective evaluation of the effectiveness of endoscopic Aqueductoplasty, performed alone or accompanied by placement of a stent, in the treatment of an isolated fourth ventricle (IFV) in seven patients afflicted with loculated hydrocephalus after a hemorrhage or infection. Seven children with symptomatic IFV and membranous Aqueductal stenosis underwent endoscopic Aqueductoplasty alone or combined with placement of a stent in the Cerebral Aqueduct. The mean age of the patients at the time of surgery was 10 months. The mean duration of follow up was 26 months. In all patients a supratentorial shunt had already been implanted, and in five patients neuroendoscopy had already been performed because other isolated compartments had been present inside the ventricular system. Aqueductoplasty alone was performed in three patients and Aqueductoplasty and Aqueductal stent placement in four. A precoronal approach was performed in five patients and a suboccipital approach in two. Signs and symptoms of intracranial hypertension resolved in all cases. Stent placement was successful in all five cases, resulting in clinical and neuroimaging-confirmed improvements in the IFV. Restenosis of the Aqueduct occurred in two patients in whom stents had not been placed. In one of these patients restenosis was managed by an endoscopic procedure, during which the Aqueduct was reopened and a stent implanted; in the other patient a shunt was placed in the fourth ventricle. Hydrocephalus was controlled by a single shunt in six cases (86%) and by a double shunt in one case. Endoscopic placement of a stent in the Aqueduct is more effective in preventing the repeated occlusion of the Aqueduct than Aqueductoplasty alone and should be indicated as the initial treatment in each case of compatible anatomy.

Yuichiro Kikkawa - One of the best experts on this subject based on the ideXlab platform.

  • Use of flexible endoscopic aspiration for an intraventricular small floating clot with hemorrhage: a technical note
    Neurosurgical Review, 2020
    Co-Authors: Hiroaki Neki, Aoto Shibata, Hiroyuki Komine, Shinya Kohyama, Fumitaka Yamane, Shoichiro Ishihara, Yuichiro Kikkawa
    Abstract:

    Background Although flexible endoscopy is effective for intraventricular lesions, it is less frequently used for hemorrhagic cases. In some hemorrhagic strokes, blood clots may plunge into the Cerebral Aqueduct and cause acute obstructive hydrocephalus. A flexible endoscope can aspirate clots and prevent acute hydrocephalus. Methods Here, we report four cases of hemorrhage: one of intraCerebral hemorrhage and three of subarachnoid hemorrhages. Results In all cases, acute hydrocephalus was not apparent upon admission. Sudden comatose occurred; computed tomography revealed acute obstructive hydrocephalus with a strangulated clot in the Cerebral Aqueduct. We performed aspiration of the strangulated clot using a flexible endoscope. Consciousness improved in all cases, and acute hydrocephalus was prevented in all cases. Conclusion The use of simple flexible endoscopic aspiration for clots might be a beneficial and less-invasive procedure for acute obstructive hydrocephalus caused by a small clot with hemorrhagic stroke.

  • Use of flexible endoscopic aspiration for an intraventricular small floating clot with hemorrhage: a technical note
    Neurosurgical review, 2020
    Co-Authors: Hiroaki Neki, Aoto Shibata, Hiroyuki Komine, Shinya Kohyama, Fumitaka Yamane, Shoichiro Ishihara, Yuichiro Kikkawa
    Abstract:

    Although flexible endoscopy is effective for intraventricular lesions, it is less frequently used for hemorrhagic cases. In some hemorrhagic strokes, blood clots may plunge into the Cerebral Aqueduct and cause acute obstructive hydrocephalus. A flexible endoscope can aspirate clots and prevent acute hydrocephalus. Here, we report four cases of hemorrhage: one of intraCerebral hemorrhage and three of subarachnoid hemorrhages. In all cases, acute hydrocephalus was not apparent upon admission. Sudden comatose occurred; computed tomography revealed acute obstructive hydrocephalus with a strangulated clot in the Cerebral Aqueduct. We performed aspiration of the strangulated clot using a flexible endoscope. Consciousness improved in all cases, and acute hydrocephalus was prevented in all cases. The use of simple flexible endoscopic aspiration for clots might be a beneficial and less-invasive procedure for acute obstructive hydrocephalus caused by a small clot with hemorrhagic stroke.

Roham Moftakhar - One of the best experts on this subject based on the ideXlab platform.

  • Endoscopically-assisted resection of a choroid plexus vascular malformation traversing the Cerebral Aqueduct: technical case report.
    Neurosurgery, 2006
    Co-Authors: Roham Moftakhar, M. Shahriar Salamat, Soner Sahin, Bermans J Iskandar
    Abstract:

    OBJECTIVE: We report a case of a choroid plexus vascular malformation of the Cerebral Aqueduct, third, and fourth ventricles of an adolescent female that was resected with endoscopic assistance. CLINICAL PRESENTATION: A 14-year-old girl presented with a 1-week history of headaches and emesis. A noncontrasted computed tomographic scan of the head demonstrated enlarged lateral and third ventricles. Subsequent magnetic resonance imaging scans with and without contrast revealed an enhancing mass originating in the third ventricle, traversing the Cerebral Aqueduct, and terminating in the fourth ventricle. RESULTS: We used a suboccipital approach to remove the vascular malformation after endoscopically disconnecting it from its feeding and draining vessels in the third ventricle. Total excision was performed. Postoperative magnetic resonance imaging scans and arteriograms confirmed complete resection of the vascular malformation. CONCLUSION: Choroid plexus vascular malformations can exist intraventricularly and can be confused with a neoplasm. Resection of these intraventricular lesions can be performed with endoscopic assistance.

  • Endoscopically-assisted resection of a choroid plexus vascular malformation traversing the Cerebral Aqueduct: technical case report.
    Neurosurgery, 2006
    Co-Authors: Roham Moftakhar, M. Shahriar Salamat, Soner Sahin, Bermans J Iskandar
    Abstract:

    We report a case of a choroid plexus vascular malformation of the Cerebral Aqueduct, third, and fourth ventricles of an adolescent female that was resected with endoscopic assistance. A 14-year-old girl presented with a 1-week history of headaches and emesis. A noncontrasted computed tomographic scan of the head demonstrated enlarged lateral and third ventricles. Subsequent magnetic resonance imaging scans with and without contrast revealed an enhancing mass originating in the third ventricle, traversing the Cerebral Aqueduct, and terminating in the fourth ventricle. We used a suboccipital approach to remove the vascular malformation after endoscopically disconnecting it from its feeding and draining vessels in the third ventricle. Total excision was performed. Postoperative magnetic resonance imaging scans and arteriograms confirmed complete resection of the vascular malformation. Choroid plexus vascular malformations can exist intraventricularly and can be confused with a neoplasm. Resection of these intraventricular lesions can be performed with endoscopic assistance.

Giuseppe Maggi - One of the best experts on this subject based on the ideXlab platform.

  • endoscopic Aqueductoplasty and placement of a stent in the Cerebral Aqueduct in the management of isolated fourth ventricle in children
    Journal of Neurosurgery, 2006
    Co-Authors: Giuseppe Cinalli, Pietro Spennato, Luciano Savarese, Claudio Ruggiero, Ferdinando Aliberti, Lorenzo Cuomo, Emilio Cianciulli, Giuseppe Maggi
    Abstract:

    Object. In this study the authors conducted a retrospective evaluation of the effectiveness of endoscopic Aqueductoplasty, performed alone or accompanied by placement of a stent, in the treatment of an isolated fourth ventricle (IFV) in seven patients afflicted with loculated hydrocephalus after a hemorrhage or infection. Methods. Seven children with symptomatic IFV and membranous Aqueductal stenosis underwent endoscopic Aqueductoplasty alone or combined with placement of a stent in the Cerebral Aqueduct. The mean age of the patients at the time of surgery was 10 months. The mean duration of follow up was 26 months. In all patients a supratentorial shunt had already been implanted, and in five patients neuroendoscopy had already been performed because other isolated compartments had been present inside the ventricular system. Aqueductoplasty alone was performed in three patients and Aqueductoplasty and Aqueductal stent placement in four. A precoronal approach was performed in five patients and a suboccipital approach in two. Signs and symptoms of intracranial hypertension resolved in all cases. Stent placement was successful in all five cases, resulting in clinical and neuroimaging-confirmed improvements in the IFV. Restenosis of the Aqueduct occurred in two patients in whom stents had not been placed. In one of these patients restenosis was managed by an endoscopic procedure, during which the Aqueduct was reopened and a stent implanted; in the other patient a shunt was placed in the fourth ventricle. Hydrocephalus was controlled by a single shunt in six cases (86%) and by a double shunt in one case. Conclusions. Endoscopic placement of a stent in the Aqueduct is more effective in preventing the repeated occlusion of the Aqueduct than Aqueductoplasty alone and should be indicated as the initial treatment in each case of compatible anatomy.

  • Endoscopic Aqueductoplasty and placement of a stent in the Cerebral Aqueduct in the management of isolated fourth ventricle in children.
    Journal of neurosurgery, 2006
    Co-Authors: Giuseppe Cinalli, Pietro Spennato, Luciano Savarese, Claudio Ruggiero, Ferdinando Aliberti, Lorenzo Cuomo, Emilio Cianciulli, Giuseppe Maggi
    Abstract:

    In this study the authors conducted a retrospective evaluation of the effectiveness of endoscopic Aqueductoplasty, performed alone or accompanied by placement of a stent, in the treatment of an isolated fourth ventricle (IFV) in seven patients afflicted with loculated hydrocephalus after a hemorrhage or infection. Seven children with symptomatic IFV and membranous Aqueductal stenosis underwent endoscopic Aqueductoplasty alone or combined with placement of a stent in the Cerebral Aqueduct. The mean age of the patients at the time of surgery was 10 months. The mean duration of follow up was 26 months. In all patients a supratentorial shunt had already been implanted, and in five patients neuroendoscopy had already been performed because other isolated compartments had been present inside the ventricular system. Aqueductoplasty alone was performed in three patients and Aqueductoplasty and Aqueductal stent placement in four. A precoronal approach was performed in five patients and a suboccipital approach in two. Signs and symptoms of intracranial hypertension resolved in all cases. Stent placement was successful in all five cases, resulting in clinical and neuroimaging-confirmed improvements in the IFV. Restenosis of the Aqueduct occurred in two patients in whom stents had not been placed. In one of these patients restenosis was managed by an endoscopic procedure, during which the Aqueduct was reopened and a stent implanted; in the other patient a shunt was placed in the fourth ventricle. Hydrocephalus was controlled by a single shunt in six cases (86%) and by a double shunt in one case. Endoscopic placement of a stent in the Aqueduct is more effective in preventing the repeated occlusion of the Aqueduct than Aqueductoplasty alone and should be indicated as the initial treatment in each case of compatible anatomy.