کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3097078 1581482 2012 10 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Transventricular Neuroendoscopic Exploration and Biopsy of the Basal Cisterns in Patients with Basal Meningitis and Hydrocephalus
موضوعات مرتبط
علوم زیستی و بیوفناوری علم عصب شناسی عصب شناسی
پیش نمایش صفحه اول مقاله
Transventricular Neuroendoscopic Exploration and Biopsy of the Basal Cisterns in Patients with Basal Meningitis and Hydrocephalus
چکیده انگلیسی

BackgroundManagement of communicating hydrocephalus associated with infectious meningitis and arachnoiditis of the basal cisterns can be challenging if no microorganism or pathological diagnosis is established. The purpose of our series is to elucidate the efficacy of endoscopic basal cistern exploration, biopsy, and endoscopic third ventriculostomy (ETV) in patients with basal cistern meningitis and hydrocephalus.MethodsBetween 2005 and 2010, all patients who underwent transventricular endoscopic exploration biopsy and biopsy of the basal cisterns were analyzed and prospectively followed up. Particular attention was given to neuroendoscopic findings, sensitivity of biopsy, and the role of ETV.ResultsTwenty-four patients, ranging in age from 2 to 63 years, underwent transventricular endoscopic biopsy and exploration of the basal cisterns. All patients had negative cerebrospinal fluid analysis obtained by lumbar puncture. Successful ETV, exploration, dissection, and biopsy of the basal cisterns were performed successfully in all patients with a flexible neuroendoscope. Neuroendoscopic findings included: unusually thick Liliequist membrane, moderate to severe adhesive arachnoiditis, inflammatory and cotton-like exudates, granulations, and narrow subarachnoid space. Definitive histopathological diagnosis from the basal cisterns specimen was obtained in 79% of patients. There were no complications related to the procedure. At 15 months of follow-up, 70% of the patients with hydrocephalus did not require a ventriculoperitoneal shunt.ConclusionsEndoscopic transventricular basal cisterns exploration is feasible with a flexible neuroendoscope. It is a viable alternative in the management of patients with basal cistern meningitis and arachnoiditis without histopathological diagnosis. It yields to an accurate diagnosis in 79% of the patients. ETV is a good alternative in the management of intracisternal extraventricular obstructive hydrocephalus.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: World Neurosurgery - Volume 77, Issues 5–6, May–June 2012, Pages 762–771
نویسندگان
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