Document Detail

Neuroendoscopic aqueductal stent placement procedure for isolated fourth ventricle after ventricular shunt placement. Case report.
MedLine Citation:
PMID:  10839267     Owner:  NLM     Status:  MEDLINE    
Isolated fourth ventricle (IFV) is a rare complication in patients who undergo shunt placement, and it is not easily corrected by surgical procedures. The authors report a case of IFV that was successfully treated with an aqueductal stent placed under direct visualization by using a neuroendoscope. This 36-year-old suffered meningitis after partial resection of a brainstem pilocytic astrocytoma, and subsequently developed hydrocephalus for which a ventriculoperitoneal shunt was placed. Nine months later, the patient presented with progressive cerebellar ataxia, and magnetic resonance imaging revealed slitlike supratentorial ventricles and a markedly enlarged fourth ventricle, which were compatible with the diagnosis of IFV. The surgical procedure described was performed under visualization through a styletlike slim optic fiberscope inserted into a ventricular catheter. The catheter, with the endoscope inside it, was passed through the foramen of Monro and then through the aqueduct to reach the enlarged fourth ventricle, where membranous occlusion of the foramen of Magendie was clearly visualized. The tip of the catheter was placed in the fastigium of the fourth ventricle. After the procedure, the size of the fourth ventricle was reduced and the patient's symptoms improved. Thus, it is concluded that endoscopic aqueductal stent placement is a simple and safe surgical procedure for treatment of IFV.
M Shin; A Morita; S Asano; K Ueki; T Kirino
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  92     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2000 Jun 
Date Detail:
Created Date:  2000-06-14     Completed Date:  2000-06-14     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1036-9     Citation Subset:  AIM; IM    
Department of Neurosurgery, The University of Tokyo Hospital, Japan.
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MeSH Terms
Brain Diseases / diagnosis,  etiology*,  surgery*
Cerebral Aqueduct / surgery*
Cerebral Ventricles* / pathology
Cerebral Ventriculography
Equipment Design
Fiber Optic Technology / instrumentation
Magnetic Resonance Imaging
Neurosurgery / instrumentation
Tomography, X-Ray Computed
Ventriculoperitoneal Shunt / adverse effects*

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