RESUMO
The first step in endovascular treatment is the stable placement of a guide catheter (GC) into the target parent vessel. However, sufficient GC stabilization is sometimes difficult to obtain when the approach route has severe tortuosity. Here, we report our experience with and the usefulness of the 8 French (Fr) Newton-shaped Neuro-EBU vascular catheter (SILUX Co., Ltd., Kawaguchi City, Saitama Prefecture, Japan), which is rigid over its entire length except near the tip, in a case series of 21 patients. Of the 21 cases, 19 cases were successfully treated using the Neuro-EBU. The 8 Fr Newton-shaped Neuro-EBU might be useful both as a special GC and as a wire exchange catheter when placement of the conventional GC is difficult due to severe tortuosity of the access route. Although rarely used, the Neuro-EBU catheter can serve as a practical alternative when the access route is challenging. To the best of our knowledge, there are no detailed reports on the technical use of the Newton-shaped vascular catheter in the field of neurointervention. We present the usefulness of the specially shaped 8 Fr guide catheter.
RESUMO
Background: Glioependymal cysts (GECs) are rare, benign congenital intracranial cysts that account for 1% of all intracranial cysts. Surgical interventions are required for patients with symptomatic GECs. However, the optimal treatment remains controversial, especially in infants. Here, we report a male infant case of GECs that successfully underwent minimally invasive combined neuroendoscopic cyst wall fenestration and cyst-peritoneal (CP) shunt. Case Description: The boy was delivered transvaginally at 38 weeks and 6 days of gestation with no neurological deficits. Magnetic resonance imaging (MRI) at birth revealed multiple cysts with smooth and rounded borders and a non-enhancing wall in the right parieto-occipital region. The size of the cyst had increased rapidly compared to that of the prenatal MRI, which was performed at 37 weeks and 2 days. On the day of birth, Ommaya cerebrospinal fluid (CSF) reservoir was placed into the largest outer cyst. The patient underwent intermittent CSF drainage; however, he experienced occasional vomiting. At 2 months, he underwent combined neuroendoscopic cyst wall fenestration and CP shunt through a small hole. The patient's postoperative course was uneventful and there was no recurrence of the cyst. The pathological diagnosis was GEC. Conclusion: Combined neuroendoscopic cyst wall fenestration and CP shunt are a minimally invasive and effective treatment for infants with GECs.
