Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-10T06:20:41.617Z Has data issue: false hasContentIssue false
  • English
  • Français

Anterograde Ventricular Irrigation During Fourth Ventricle Region Surgery

Published online by Cambridge University Press:  02 December 2014

Ian G. Fleetwood  and
Mark G. Hamilton
Ian G. Fleetwood
Affiliation:
Division of Neurosurgery, Dalhousie University, Department of Surgery, Halifax Infirmary, Halifax, NS, Canada
Mark G. Hamilton
Affiliation:
University of Calgary, Department of Clinical Neurosciences, Alberta Children’s Hospital, Calgary, AB, Canada
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

To reduce postoperative hydrocephalus following surgery in the region of the fourth ventricle.

Method/technique:

We describe the use of a conventionally placed lateral ventricular catheter to facilitate anterograde ventricular irrigation during surgery in the region of the fourth ventricle. This technique offers a safe alternative to more conventional approaches to fourth ventricular irrigation and obviates the need for placement of a third or fourth ventricular catheter and/or serial lumbar punctures by thoroughly flushing blood and tissue debris from the operative field at the time of surgery.

Results:

Preliminary results spanning a five-year period show a lower incidence in the need for early ventriculo-peritoneal shunts (5%) and delayed ventriculo-peritoneal shunts (10%).

Conclusion:

This technique represents a safe method of reducing hydrocephalus following operative procedures in the region of the fourth ventricle.

Résumé:

RÉSUMÉ:Objectif:

Réduire l’hydrocéphalie postopératoire dans les cas de chirurgie de la région du quatrième ventricule.

Méthode/technique:

Nous décrivons l’utilisation d’un cathéter ventriculaire latéral placé de façon conventionnelle pour faciliter l’irrigation ventriculaire antérograde pendant la chirurgie de la région du quatrième ventricule. Cette technique offre une alternative sûre aux approches conventionnelles de l’irrigation du quatrième ventricule et évite d’avoir recours à la mise en place d’un cathéter dans le troisième ou le quatrième ventricule et/ou à des ponctions lombaires répétées en évacuant complètement le sang et les débris tissulaires du champ opératoire pendant la chirurgie.

Résultats:

Les résultats préliminaires obtenus sur cinq ans montrent que moins de patients ont eu besoin d’une dérivation ventricule–péritonéale de façon précoce (5%) ou tardive (10%).

Résultats:

Cette technique est une méthode sûre pour diminuer l’hydrocéphalie postopératoire suite à une chirurgie de la région du quatrième ventricule.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 32 , Issue 1 , February 2005 , pp. 57 - 60
Copyright
Copyright © The Canadian Journal of Neurological 2014

References

1. Schmidek, HH. Surgical management of cerebellar tumours inadults. In: Schmidek, HH, Sweet, WH (Eds). Operative Neurosurgical Techniques: Indications, Methods and Results. Philadelphia: WB Saunders, 1995: 791–800.Google Scholar
2. Hoffman, HJ. Ependymomas and fourth ventricular tumours. In: Apuzzo, MJ (Ed). Brain Surgery: Complication Avoidance and Management. New York: Churchill Livingstone, 1993: 1849–1860.Google Scholar
3. Albright, L. Posterior fossa tumors. Neurosurg Clin N Am 1992; 3: 881–891.Google Scholar
4. Petronio, J, Walker, ML. Surgical management of cerebellar tumoursin children. In: Schmidek, HH, Sweet, WH (Eds). Operative Neurosurgical Techniques: Indications, Methods and Results. Philadelphia: WB Saunders, 1995: 801–812.Google Scholar
5. Cochrane, DD, Gustavsson, B, Poskitt, KP, Steinbok, P, Kestle, JR. Thes u rgical and natural morbidity of aggressive resection for posterior fossa tumors in childhood. Pediatr Neurosurg 1994; 20: 19–29.Google Scholar
6. Griwan, MS, Sharma, BS, Mahajan, RK, Kak, VK. Value ofprecraniotomy shunts in children with posterior fossa tumours. Childs Nerv Syst 1993; 9: 462–466.CrossRefGoogle ScholarPubMed
7. Mapstone, TB, Ratcheson, RA. Techniques of ventricular puncture. In: Wilkins, RH, Rengachary, SS (Eds). Neurosurgery. New York: McGraw Hill, 1996: 179–184.Google Scholar
8. Dias, MS, Albright, AL. Management of hydrocephalus complicatingchildhood posterior fossa tumors. Pediatr Neurosci 1989; 15: 283–290.Google Scholar
9. Kumar, V, Phipps, K, Harkness, W, Hayward, RD. Ventriculo-peritoneal shunt requirement in children with posterior fossa tumours: an 11-year audit. Br J Neurosurg 1996; 10: 467–470.Google Scholar
10. Rekate, HL, McCormick, J, Yamada, K. An analysis of the need forshunting after brain tumour surgery. In: Marlin, AE (Ed). Concepts in Pediatric Neurosurgery. Basel: S. Karger Publishing, 1991: 39–46.Google Scholar
11. Lee, M, Wisoff, JH, Abbott, R, Freed, D, Epstein, FJ. Management ofhydrocephalus in children with medulloblastoma: prognostic factors for shunting. Pediatr Neurosurg 1994; 20: 240–247.Google Scholar
12. Albright, AL, Wisoff, JH, Zeltzer, PM, et al. Current neurosurgicaltreatment of medulloblastomas in children. A report from the Children’s Cancer Study Group. Pediatr Neurosci 1989; 15: 276–282.Google Scholar
13. Smoots, DW, Geyer, JR, Lieberman, DM, Berger, MS. Predictingdisease progression in childhood cerebellar astrocytoma. Childs Nerv Syst 1998; 14: 636–648.Google Scholar
14. Modha, A, Vassilyadi, M, George, A, et al. Medulloblastoma inchildren – the Ottawa experience. Childs Nerv Syst 2000; 16: 341–350.Google Scholar
15. Culley, DJ, Berger, MS, Shaw, D, Geyer, R. An analysis of factorsdetermining the need for ventriculoperitoneal shunts after posterior fossa tumor surgery in children. Neurosurgery 1994; 34: 402–408.Google Scholar
16. Cinalli, G. Alternatives to shunting. Childs Nerv Syst 1999; 15: 718–731.CrossRefGoogle ScholarPubMed
17. Jenkin, D, Shabanah, MA, Shail, EA, et al. Prognostic factors formedulloblastoma. Int J Radiat Oncol Biol Phys 2000; 47: 573–584.Google Scholar
18. Belza, MG, Donaldson, SS, Steinberg, GK, Cox, RS, Cogen, PH. Medulloblastoma: freedom from relapse longer than 8 years – a therapeutic cure? J Neurosurg 1991; 75: 575–582.Google Scholar
19. Goel, A. Whither preoperative shunts for posterior fossa tumours? Br J Neurosurg 1993; 7: 395–399.Google Scholar
20. David, KM, Casey, AT, Hayward, RD, et al. Medulloblastoma: is the 5-year survival rate improving? A review of 80 cases from a single institution. J Neurosurg 1997; 86: 13–21.Google Scholar
21. Schroeder, HW, Gaab, MR. Endoscopic aqueductoplasty: techniqueand results. Neurosurgery 1999; 45: 508–515.Google Scholar
22. Lee, M, Leahu, D, Weiner, HL, et al. Complications of fourth-ventricular shunts. Pediatr Neurosurg 1995; 22: 309–314.Google Scholar