ABSTRACT
This study aims to review historical aspects and rebirth of the endoscopic choroid plexus coagulation (CPC) for pediatric hydrocephalus. The first CPC procedure goes back to early 1930s. After the development of other treatment methods and the understanding of CSF dynamics, the application of CPC dramatically decreased by 1970s. In 2000s, there was a rebirth of CPC in combination with endoscopic third ventriculostomy (ETV), and remains one of the options for the treatment of pediatric hydrocephalus in selected cases. CPC might provide a temporary reduction in CSF production to allow the further development of CSF absorption in infant, and adding to ETV for infants with communicating hydrocephalus may increase the shunt independent rate thus avoiding the consequence of late complication related to the shunt device. This is important for patients who are difficult to be followed up, due to geographical and/or socioeconomic difficulties. And also adding CPC to ETV for obstructive hydrocephalus in infants younger than 1 year of age may also increase the successful rate. Furthermore, CPC may be an option for cases with high chance of shunt complication such as multiloculated hydrocephalus, extreme hydrocephalus and hydranencephaly. In comparison with the traditional treatment of CSF shunting, the role of CPC needs to be further evaluated in particular concerning the neurocognitive development.
Subject(s)
Humans , Infant , Electrocoagulation , Hydrocephalus/surgery , Neuroendoscopy/methods , Choroid Plexus/surgery , Blood Coagulation , Cautery , Third Ventricle/surgery , Ventriculostomy/methodsABSTRACT
Os autores apresentam o estudo da anatomia microcirúrgica do corpo da fissura coroidéia, baseado na dissecçao de 10 encéfalos humanos com auxílio de microscópio cirúrgico. As distância médias encontradas entre a físsura coroidéia e as seguintes estruturas foram, respectivamente, de: aderência intertalâmica, 12,8 mm; assoalho do terceiro ventrículo, 19,2 mm; comissura anterior, 16,0 mm; comissura posterior, 20,4 mm. Esses achados foram analisados e correlacionados com aspectos neurocirúrgicos da abordagem da regiao do corpo da físsura coroidéia ao III ventrículo.
Subject(s)
Humans , Cerebrum/physiology , Choroid Plexus/surgery , Dissection , In Vitro Techniques , Autopsy , Microsurgery/instrumentationSubject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Central Nervous System Diseases/surgery , Neurosurgical Procedures/methods , Endoscopy/methods , Arachnoid Cysts/surgery , Brain Neoplasms/surgery , Cerebral Hemorrhage/surgery , Chemoprevention , Choroid Plexus/surgery , Meningomyelocele/surgery , Postoperative Complications , Endoscopy/instrumentation , Tomography, X-Ray Computed , VentriculostomyABSTRACT
En el presente trabajo se investigó la incidencia como manejo y evolución de pacientes con tumor intracraneal. El diagnóstico se confirmó con estudio histopatológico y los resultados obtenidos se evaluaron con el Rating de Karnofsky. De 1556 pacientes operados se encontró 54 casos (3.47 por ciento) de tumores intracraneales de los que 33.34 por ciento correspondian a gliomas, 31.48 por ciento a adenomas, 24.08 por ciento a meningiomas, papilomas de plexos coroideos y craneofaringiomas con 3.70 por ciento cada uno, finalmente el neurinoma del acústico y carcinoma de plexos coroideos con 1.85 por ciento. El sexo más afectado fue el masculino 74.07 por ciento y la edad más comprometida fue la quinta década de la vida (20.37 por ciento). Todos los pacientes recibieron tratamiento quirúrgico; 45 con cirugía total, 7 con parcial, 1 con descomprensiva y 1 con cirugía derivativa. En el post operatorio inmediato 50.02 por ciento tuvieron 80 a 90 en el Rating de Karnofsky y 18.50 por ciento estuvieron por debajo de 70. El resultado final arrojó 42.59 por ciento de pacientes aliviados, 38.86 por ciento de sanos y una mortalidad de 18.52 por ciento. Los resultados de este trabajo fueron comparados con otras casuísticas nacionales y extranjeras.