Endoscopic Third Ventriculostomy

Endoscopic third ventriculostomy (ETV) is a minimally invasive procedure commonly used to treat obstructive hydrocephalus. The objectives of the procedure are to fenestrate the floor of the third ventricle using a neuroendoscopic approach and to provide a cerebrospinal fluid (CSF) diversion. With high success rates published over the years, ETV became a routine modality for the obstructive hydrocephalus treatment. Furthermore, indications for ETV are expanding day by day and are no longer limited to obstructive hydrocephalus. Endoscopic third ventriculostomy has lower complication rate and has significant advantages compared to other CSF diversion techniques. Efficiency and safety of ETV are increasing with the advancements in technology

Mnogie atypowe nawrotowe oponiaki po 13 latach od radioterapii z powodu jednostronnego siatkówczaka: opis przypadku i przegląd piśmiennictwa

Radiotherapy is an important treatment modality for intracranial malignancies. Improved survival rates were achieved via a combination of surgery, chemotherapy and radiotherapy. On the other hand, improved survival rates made long-term complications of radiotherapy more apparent. Secondary neoplasms due to cranial irradiation are encountered more commonly in neurosurgical practice. Radiation-induced meningiomas are recognized as a common late complication of radiotherapy. However, radiation-induced meningiomas after radiotherapy for retinoblastoma have been reported rarely. Herein we report a patient who harboured multiple meningiomas 13 years after radiotherapy for unilateral retinoblastoma, which were recurrent despite surgical removal and chemotherapy.Radioterapia jest ważną metodą leczenia złośliwych guzów śródczaszkowych. Dzięki łącznemu stosowaniu leczenia chirurgicznego, chemioterapii i radioterapii osiąga się zwiększony odsetek przeżyć, ale jednocześnie sprawia to, że częściej ujawniają się odległe powikłania radioterapii. Guzy wtórne do napromieniania w obrębie głowy są znanymi i częstymi powikłaniami radioterapii. Rzadko opisywano jednak oponiaki wywołane napromienianiem prowadzonym z powodu siatkówczaka. W niniejszym artykule opisano przypadek pacjenta, u którego po 13 latach od radioterapii z powodu jednostronnego siatkówczaka wystąpiły mnogie oponiaki, które miały charakter nawracający mimo leczenia chirurgicznego i chemioterapii

Full-endoscopic removal of third ventricular colloid cysts: technique, results, and limitations

IntroductionColloid cysts (CCs) are rare benign lesions that usually arise from the roof of the third ventricle. They may present with obstructive hydrocephalus and cause sudden death. Treatment options include ventriculoperitoneal shunting, cyst aspiration, and cyst resection microscopically or endoscopically. This study aims to report and discuss the full-endoscopic technique for removing colloid cysts.Materials and methodsA 25°-angled neuroendoscope with an internal working channel diameter of 3.1 mm and a length of 122 mm is used. The authors described the technique of resecting a colloid cyst by a full-endoscopic procedure and evaluated the surgical, clinical, and radiological results.ResultsTwenty-one consecutive patients underwent an operation with a transfrontal full-endoscopic approach. The swiveling technique (grasping the cyst wall and rotational movements) was used for CC resection. Of these patients, 11 were female, and ten were male (mean age, 41 years). The most frequent initial symptom was a headache. The mean cyst diameter was 13.9 mm. Thirteen patients had hydrocephalus at admission, and one needed shunting after cyst resection. Seventeen patients (81%) underwent total resection; 3 (14%), subtotal resection; and 1 (5%), partial resection. There was no mortality; one patient had permanent hemiplegia, and one had meningitis. The mean follow-up period was 14 months.ConclusionEven though microscopic resection of cysts has been widely used as a gold standard, successful endoscopic removal has been described recently with lower complication rates. Applying angled endoscopy with different techniques is essential for total resection. Our study is the first case series to show the outcomes of the swiveling technique with low recurrence and complication rates

Intrathecal baclofen use in the management of tetanus related spasm: A case report

Tetanus is an infectious disease of the central nervous system with high mortality rates characterized with respiratory distress and tonic muscle spasms. The most common cause of mortality is cardiovascular complications (40%) and respiratory distress (15%). Despite vaccination programs, tetanus remains to be a significant healthcare issue in developing nations. Prolonged sedation and administration of muscle relaxants prolongs the period on mechanical ventilation and duration of hospitalization in severe tetanus cases. However, intrathecal baclofen (ITB) therapy might shorten the duration of stay at intensive care units, improve patient outcomes, and constitute a treatment option alternative to paralytic agents and sedation. In this manuscript, we present a 12-years-old case diagnosed with tetanus and treated with ITB upon observation of spasms refractory to high dose sedation and muscle relaxants