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Image Guided Neuroendoscopy for Third Ventriculostomy 总被引:4,自引:0,他引:4
Summary Third ventriculostomy has become an increasing popular procedure for the treatment of hydrocephalus of different aetiologies.
Between october 1997 and october 1998, 17 patients (12 females, 5 males; 12–82 year-old; mean age 43) underwent image-assisted
endoscopic third ventriculostomy for hydrocephalus at the Istituto Nazionale Neurologico “C.Besta” of Milano. There was no
mortality and no long term morbidity. Neuronavigation has been found useful in selecting the safest trajectory to the target
avoiding any traction on the foramen of Monro related structures and allowing the necessary mobility for fine adjustments
under visual and “tactile” control when choosing the safest point to perform the stoma.
According to our experience neuro-endoscopy and neuronavigation seems to be complementary in reaching easy, safe and successful
results in the treatment of hydrocephalus of different origins. 相似文献
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目的 探讨神经内镜微创与开颅微创血肿清除术治疗高血压脑出血的临床疗效.方法 选择2013年5月-2016年4月在潍坊医学院附属医院神经外科住院行颅内血肿清除术的符合入选标准的脑出血患者86例,按照手术治疗方式的不同,分为神经内镜微创治疗组(内镜组)以及开颅微创血肿清除术组(开颅组),比较两组患者的围手术期情况以及术后半年的GOS预后评分.结果 内镜组的手术时间以及术中出血量显著少于开颅组(P<0.05).内镜组的血肿清除率显著高于开颅组(P<0.05).内镜组的术后再出血率低于开颅组.两组患者消化道出血、尿路感染以及下肢深静脉血栓形成等术后并发症差异无统计学意义(P>0.05),内镜组的术后肺部感染发生例数显著低于开颅组(P<0.05).内镜组半年后GOS预后评分显著优于开颅组(P<0.05).结论 神经内镜微创治疗能显著减少高血压脑出血患者手术时间、术中出血量以及术后并发症,提高血肿清除率,有助于患者的预后. 相似文献
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目的探讨神经内镜和微骨窗入路血肿清除术及保守治疗在基底节区高血压性脑出血治疗中的效果及预后,以期更好的为临床治疗提供参考。方法回顾分析72例高血压性基底节区脑出血病例,其中神经内镜治疗22例,微骨窗入路开颅手术治疗25例,保守治疗25例,比较手术血肿清除率、住院期间并发症发生率、住院好转天数、住院期间死亡率及远期疗效。结果三组在血肿清除率、住院期间并发症发生率方面差异有统计学意义;而远期疗效、住院期间死亡率上相比,三组无显著统计学差异。结论神经内镜手术治疗高血压性基底节区脑出血优于微骨窗入路血肿清除术和保守治疗,是一种损伤轻、疗效好的微创治疗方法。 相似文献
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目的探讨神经内镜手术治疗脑室内肿瘤的临床疗效及经验.方法回顾性分析16例经神经内镜手术治疗的脑室内肿瘤的临床资料,其中肿瘤单纯位于侧脑室8例,第三脑室6例,同时位于侧脑室和第三脑室2例.结果肿瘤全切除4例,部分切除8例,囊性颅咽管瘤经囊腔内置Ommaya管术后囊腔明显缩小4例.术后根据病理检查对部分病例进行放射治疗.均无明显手术并发症.随访2~36个月,平均15.7个月,无死亡病例,第三脑室内生殖细胞瘤复发1例,第三脑室内囊性颅咽管瘤囊腔扩大1例.结论神经内镜手术治疗脑室内肿瘤具有微创、手术视野好、并发症少等优点,是一种有效的诊疗手段. 相似文献
6.
Development and preliminary assessment of a robotic platform for neuroendoscopy based on a lightweight robot
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Summary ?Background. Endoscopy has developed into an integral part of minimally invasive neurosurgery. For further technological innovations,
detailed knowledge about the pathological anatomy is essential. The gross anatomy of the cerebral ventricular system has been
meticulously investigated with ventriculography and casts. Extensive volumetric measurements based on neuroradiological images
have been performed, but only little is known about the surgically relevant linear distances in patients with hydrocephalus.
Method. Thirty healthy volunteers and thirty patients suffering from hydrocephalus were scanned with high-resolution 3-D magnetic
resonance imaging sequences. The image volumes were sliced identically with the help of Siemens Prominence? software. Individual anatomical measurements of the ventricular system were carried out, mean values and standard deviations
were calculated, and different endoscopic approaches were investigated.
Findings. In healthy volunteers the measurements confirmed the results obtained from ventriculography and anatomic casts. In hydrocephalic
patients the ventricular system was found to be enlarged asymmetrically. The optimal neuroendoscopic approach showed considerable,
interindividual variation.
Interpretation. This 3-D magnetic resonance imaging study revealed surgically and clinically relevant aspects of the pathologic anatomy of
hydrocephalic patients, in comparison to healthy volunteers. Individualized planning of the endoscopic approach appears to
be warranted. Finally, the data provided a sound basis for the further development of neuroendoscopes.
Published online June 4, 2003 相似文献