| Manual occipital ventricular puncture for cerebrospinal fluid shunt surgery: can aiming be standardized? | |
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MedLine Citation:
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PMID: 15347211 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The manual occipital ventricular puncture is a standard surgical procedure, but specific targeting has not received sufficient attention despite the experience of anatomical disorientation. This study tried to identify an exact site for the ideal trajectory with this method, especially in the sagittal plane, which avoids contact with the choroid plexus that may be the major source of complications. A total of 44 consecutive adult cases undergoing cerebrospinal fluid shunting through the occipital route for hydrocephalus were retrospectively reviewed for the following: correlations between burr hole site, direction of puncture, and location of the ventricular catheter based on postsurgical radiological studies; calculation of the ideal trajectory to place the catheter tip in the anterior horn of the lateral ventricle without contact with the choroid plexus through the standard occipital burr hole. In addition, the relationships between the location of the ventricular structure, the cranial base line connecting the nasion and inion, and the size of the ventricle were evaluated. Incorrect catheter emplacement was found in five cases, which suggested that this procedure using the standard burr hole site and aim point might result in incorrect catheter placement. The ideal external aim points were widely distributed because of the variable heights of ventricular structures from the cranial baseline. No correlation between the locations of the anatomical points and ventricular size was found. The present study could not define a standard external aim point. Tailored preoperative planning of the trajectory is recommended. |
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Authors:
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Satoru Shimizu; Ryusui Tanaka; Hideo Iida; Kiyotaka Fujii |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Neurologia medico-chirurgica Volume: 44 ISSN: 0470-8105 ISO Abbreviation: Neurol. Med. Chir. (Tokyo) Publication Date: 2004 Jul |
Date Detail:
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Created Date: 2004-09-06 Completed Date: 2004-10-25 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0400775 Medline TA: Neurol Med Chir (Tokyo) Country: Japan |
Other Details:
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Languages: eng Pagination: 353-7; discussion 358 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan. Satoru4756@aol.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Catheters, Indwelling Cerebrospinal Fluid Shunts / methods* Choroid Plexus / injuries Female Humans Hydrocephalus / radiography, surgery* Intraoperative Complications / etiology, prevention & control, radiography Male Middle Aged Models, Theoretical Occipital Bone / radiography, surgery Postoperative Complications / etiology, prevention & control, radiography Punctures* Tomography, X-Ray Computed Ventriculostomy / methods* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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