ABSTRACT
OBJECTIVE: Better visualization of the intracranial aneurysm may improve surgical outcomes. To this aim, we evaluated the effectiveness of using virtual endoscopy (VE) during intracranial aneurysm surgery. METHODS: Fifty-eight patients with 63 intracranial aneurysms were enrolled in this study. Every patient was examined by digital subtraction angiography (DSA) and a randomly selected twenty-six cases were also examined by computed tomography (CT). CT angiography data were linked via imaging software for reconstruction of VE images. All patients were operated on using standard microsurgical procedures. Among these cases, randomly selected cohorts of twenty-six patients with 28 intracranial aneurysms were operated on also using VE-assisted surgical procedures. The surgical results of both groups were compared to determine the efficacy of the VE-assisted surgical procedure. RESULTS: Aneurysm locations, surgical timing and Hunt-Hess grade distribution were not statistically significant between both groups (p=0.948). However, significantly reduced complication rates and increased post-operative Glasgow outcome scores were observed in the VE group (p<0.05) compared to control. CONCLUSION: Aneurysms and surrounding anatomic structures were well depicted by VE in three dimensions with interactive fly-through views. This method improved our surgical results by improving visualization of the aneurysm and increasing surgical orientation. We report that this method can be very helpful to surgeons during intracranial aneurysm surgery and may reduce post-surgical complications.
Subject(s)
Intracranial Aneurysm/surgery , Neuroendoscopy/methods , Neurosurgical Procedures/methods , Adult , Aged , Angiography, Digital Subtraction , Cohort Studies , Female , Glasgow Outcome Scale , Humans , Image Processing, Computer-Assisted , Intracranial Aneurysm/diagnosis , Male , Middle Aged , Tomography, Emission-Computed , Treatment OutcomeABSTRACT
Mature teratomas are rare inclusion tumors, which have benign behaviors. Different locations of the tumor were reported in the literature. However, multiple tumor locations are extremely rare. An eight year old patient presented with an intraventricularly mature teratoma. During the six year follow up-period, two separately located masses were observed in the chest area and in the right iliac region, and both tumors were histologically diagnosed as mature teratomas. In this study, this unique case of mature teratoma presented with multiple locations in three separate body compartments. Furthermore, intraventricular dissemination with sellar and parasellar extension was observed in the third ventricle.
Subject(s)
Brain Neoplasms/pathology , Lateral Ventricles/pathology , Neoplasm Metastasis/pathology , Neoplasms, Second Primary/pathology , Skull Base Neoplasms/secondary , Teratoma/pathology , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/physiopathology , Child , Fatal Outcome , Humans , Ilium/diagnostic imaging , Ilium/pathology , Lateral Ventricles/diagnostic imaging , Lateral Ventricles/physiopathology , Magnetic Resonance Imaging , Male , Neoplasm Metastasis/diagnostic imaging , Neoplasm Metastasis/physiopathology , Neoplasm Recurrence, Local , Neoplasms, Second Primary/diagnostic imaging , Neoplasms, Second Primary/physiopathology , Neurosurgical Procedures , Pelvic Neoplasms/diagnostic imaging , Pelvic Neoplasms/pathology , Pelvic Neoplasms/physiopathology , Pleural Neoplasms/diagnostic imaging , Pleural Neoplasms/pathology , Pleural Neoplasms/physiopathology , Sella Turcica/diagnostic imaging , Sella Turcica/pathology , Teratoma/diagnostic imaging , Teratoma/physiopathology , Third Ventricle/diagnostic imaging , Third Ventricle/pathology , Third Ventricle/physiopathology , Thorax/pathology , Thorax/physiopathology , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
The isolated fourth ventricle (IFV) develops in which obstruction to the out flow of cerebrospinal fluid from the choroid plexus of the fourth ventricle occurs rostrally and caudally. IFV has been a rare occurrence and is difficult to treat. We had an occasion to admit a 28-year-old female to our hospital due to hydrocephalus: she also had a history of meningitis a year ago. The patient was initially managed by a lateral ventriculo-peritoneal shunting procedure. Six months after the procedure the patient began to suffer from vomiting, nausea, and diplopia. CT and MRI scans demonstrated an isolated fourth ventricle enlargement; and thus, a fourth ventriculo-peritoneal shunting procedure was performed under stereotactic conditions. The authors present a case of an isolated fourth ventricle after lateral ventriculo-peritoneal shunting for hydrocephalus, which was treated with a stereotactically guided fourth ventriculo-peritoneal shunting procedure. The technique of this procedure is described below.
