Endoscopic placement of a triventricular stent for complex hydrocephalus and isolated fourth ventricle: illustrative case.

Autor:	Horak VJ; 2Division of Pediatric Neurosurgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.; 3Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois; and., Gulsuna B; 2Division of Pediatric Neurosurgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.; 4Department of Neurosurgery, Gazi University School of Medicine, Ankara, Turkey., LoPresti MA; 2Division of Pediatric Neurosurgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois., DeCuypere M; 1Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.; 2Division of Pediatric Neurosurgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Case lessons [J Neurosurg Case Lessons] 2023 Nov 06; Vol. 6 (19). Date of Electronic Publication: 2023 Nov 06 (Print Publication: 2023).
DOI:	10.3171/CASE23153
Abstrakt:	Background: Hydrocephalus is commonly encountered in pediatric neurosurgery. The etiology is diverse, and complexity in management increases in patients with loculated or trapped ventricles. The authors sought to examine a treatment option of endoscopic placement of a triventricular stent in a pediatric patient with complex hydrocephalus and a trapped fourth ventricle. Observations: In this case, the authors present the treatment of complex hydrocephalus with a trapped fourth ventricle in a pediatric patient using endoscopic placement of a triventricular aqueductal stent. The patient had a complex neurosurgical history, which included over 15 surgeries for shunted hydrocephalus. This case highlights the unique approach used, and the authors discuss surgical nuances of the technique, as well as learning points. Lessons: Complex hydrocephalus can be difficult to manage because patients often have multiple catheters, loculated or trapped ventricles, and extensive surgical histories. Endoscopic placement of a triventricular stent can decrease shunt system complexity, restore normal cerebrospinal fluid pathway circulation across the cerebral aqueduct, and promote communication between the ventricles. The authors' treatment modality resulted in the successful resolution of the trapped fourth ventricle and symptomatic improvement in hydrocephalus.
Databáze:	MEDLINE
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