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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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目的探讨传统开颅手术与神经内镜手术在治疗基底节区高血压脑出血(HICH)患者中的疗效与安全性,为其临床治疗提供一定依据。方法 86例基底节区HICH患者,根据手术方式不同将患者分为神经内镜组(40例)和开颅手术组(46例),开颅手术组采用开颅血肿清除手术治疗,神经内镜组采用神经内镜微创血肿清除手术治疗,对比两组基底节区HICH患者皮肤切口大小、骨窗大小、皮层切口大小、手术时间、术中出血量、血肿清除率、术后并发症、近期与远期疗效和病死率。结果神经内镜组患者的皮肤切口大小、骨窗大小、皮层切口大小、手术时间、术中出血量均明显低于开颅手术组(P 0.01);两组患者血肿清除率差异无统计学意义(P0.05);神经内镜组患者术后并发症发生率为10.0%,明显低于开颅手术组的28.3%(P 0.05);神经内镜组患者近期疗效良好率为90.0%明显高于开颅手术组的60.9%(P 0.01);神经内镜组患者远期疗效良好率为92.5%明显高于开颅手术组的63.0%(P 0.01);开颅手术组患者死亡3例,病死率6.5%;神经内镜组患者死亡2例,病死率5.0%;两组患者病死率差异无统计学意义(P0.05)。结论神经内镜手术治疗基底节区HICH可以减小手术创伤,缩短手术时间,降低出血量,提升近期与远期疗效,降低并发症发生率。 相似文献
5.
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