Complications following endoscopic intracranial procedures in children

Cinalli, Giuseppe; Spennato, Pietro; Ruggiero, Claudio; Aliberti, Ferdinando; Trischitta, Vincenzo; Buonocore, Maria Consiglio; Cianciulli, Emilio; Maggi, G

doi:10.1007/s00381-007-0333-6

Cited by 96 publications

(35 citation statements)

References 41 publications

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“…This is largely due to the proximity of the endoscope to critical neural structures, as is the case in several endoscopic procedures. 18,19 However, the incidence of complications is low, as reported in our population-based study, and varies with operative indication as well as patient age. Despite our finding that there is no statistically significant difference in complication rates between adult and pediatric patients, neuroendoscopy maintains the reputation of being a largely pediatric technique.…”

Section: Discussionmentioning

confidence: 61%

Comparison of Intracranial Neuroendoscopic Procedures in Children versus Adults

Girgis

Diaz

Hader

et al. 2015

Can. J. Neurol. Sci.

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Background: The emphasis regarding intracranial neuroendoscopy has been traditionally advocated and focused on the role in pediatric patients, although a significant usage has developed in adult patients. In this study, we examine and contrast the role of predominantly intracranial neuroendoscopy in both a pediatric and adult population with a minimum postprocedure follow-up of 5 years. Methods: A retrospective review was conducted for patients in the two hospitals that manage neurosurgical care for Southern Alberta, Canada, undergoing neuroendoscopic surgery between 1994 and 2008. The pediatric group was defined as age ≤17 years and the adult group as age ≥18 years. Results: A total of 273 patients who underwent a total of 330 procedures with a mean postprocedure follow-up of 12.9 years were identified. There were 161 adult and 112 pediatric patients, and both groups underwent surgery by the same surgeons. The most common procedure was endoscopic third ventriculostomy, accounting for 55% of procedures. One postoperative death occurred in an adult patient. Endoscopic third ventriculostomy success 1-year postprocedure was 81%, with only three late-term failures. Postoperative infection was the most common serious complication (two pediatric/four adult patients). Adult and pediatric patients had similar major complication rates (4.2% vs 5.7%, p = 0.547). Conclusions: Neuroendoscopy overall had a similar role in both pediatric and adult neurosurgical populations, with the most commonly associated complication being infection. Neuroendoscopy is an important therapeutic modality in the management of appropriate adult patients.RÉSUMÉ: Comparaison des interventions neuroendoscopiques intracrâniennes chez les enfants et chez les adultes. Contexte: Traditionnellement, l'emphase a été mise sur la neuroendoscopie intracrânienne chez les enfants et sur son rôle dans cette population de patients. Cependant, de telles interventions sont de plus en plus pratiquées chez des adultes. Nous examinons le rôle de la neuroendoscopie tant chez les enfants que chez les adultes et nous comparons son rôle dans ces deux populations de patients. Méthode: Nous avons procédé à une revue rétrospective des dossiers de patients ayant subi une chirurgie par neuroendoscopie entre 1994 et 2008 dans deux hôpitaux qui offrent des soins neurochirurgicaux dans la partie sud de l'Alberta, au Canada. Les patients du groupe pédiatrique étaient âgés de 17 ans ou moins et ceux du groupe adulte de 18 ans ou plus. Le suivi le plus court après l'intervention était de 5 ans. Résultats: Nous avons identifié 273 patients, dont 161 adultes et 112 enfants, qui ont subi au total 330 interventions, et chez qui un suivi moyen de 12,9 ans était disponible. Les deux groupes de patients ont été opérés par les mêmes chirurgiens. L'intervention la plus fréquemment effectuée était la ventriculostomie au niveau du 3e ventricule, ce qui représentait 5% des interventions. Un patient adulte est décédé en période post-opératoire. La ventriculostomie du 3e ventricule p...

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Section: Discussionmentioning

confidence: 61%

Comparison of Intracranial Neuroendoscopic Procedures in Children versus Adults

Girgis

Diaz

Hader

et al. 2015

Can. J. Neurol. Sci.

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“…As reported by Peretta and colleagues, the overall complication rate for such operative procedures is roughly 7.3 %, with CSF leaks, aborted procedures, and intraventricular hemorrhages reported as the most common causes of morbidity [49]. A number of other reported complications, albeit far more rare, include subdural hygromas, wound infections, and endocrine disturbances [48][49][50][51][52]. Regarding associated endocrine dysfunction secondary to intraoperative manipulation, the precise mechanism remains unknown, but possible involvement of the tuber cinereum, a component of the hypothalamic-pituitary axis, is implicated [53].…”

Section: Complicationsmentioning

confidence: 94%

“…Our review of recent literature (Table 1) reveals that some of the more common complications include CSF leaks, ventriculitis, meningitis, intracranial hemorrhage, and early ETV failure. Of these, hemorrhage is perhaps the most challenging intraoperative complication to manage due to the difficulty of obtaining hemostasis with endoscopic instruments [48]. As reported by Peretta and colleagues, the overall complication rate for such operative procedures is roughly 7.3 %, with CSF leaks, aborted procedures, and intraventricular hemorrhages reported as the most common causes of morbidity [49].…”

Section: Complicationsmentioning

confidence: 99%

Ventricular endoscopy in the pediatric population: review of indications

et al. 2014

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Introduction Neuroendoscopy has greatly impacted pediatric neurosurgery over the past few decades. Improved optics and microsurgical tools have allowed neuroendoscopes to be used for a multitude of neurosurgical procedures. Discussion In this review article, we present the breadth of intraventricular neuroendoscopic procedures for the treatment of conditions ranging from hydrocephalus and brain tumors to congenital cysts and other pathologies. We critically discuss treatment indications and reported success rates for neuroendoscopic procedures. We also present novel approaches, technical nuances, and variations from recently published literature and as practiced in the authors' institution.

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“…3,7,8,12) However, neuroendoscopic surgery is associated with various complications, such as subdural hygroma, infection, intraparenchymal or intraventricular hemorrhage, contusion, injury of the basilar artery, and bilateral retinal hemorrhage, although many of these were associated with endoscopic third ventriculostomy (ETV). 1,2,5,6,11) In addition, the most hazardous postoperative complication after ETV is stoma obstruction and rapid increase in the intracranial pressure in the chronic phase which may induce sudden death. 1,2,6) The obstruction of the stoma occurs as a result of regeneration of the arachnoid membrane and formation of glial scar, so is not directly related to the surgical procedure.…”

Section: Introductionmentioning

confidence: 99%

“…1,2,5,6,11) In addition, the most hazardous postoperative complication after ETV is stoma obstruction and rapid increase in the intracranial pressure in the chronic phase which may induce sudden death. 1,2,6) The obstruction of the stoma occurs as a result of regeneration of the arachnoid membrane and formation of glial scar, so is not directly related to the surgical procedure. 2) Although the incidence of such sudden death is quite low, stoma obstruction lacks warning signs and requires prompt and proper management.…”

Section: Introductionmentioning

confidence: 99%

A Pitfall of Neuroendoscopic Intraventricular Hematoma Removal - Delayed Obstructive Hydrocephalus Caused by a Small Remnant Clot -Case Report-

Komatsu

Wakuta

Komatsu

et al. 2011

Neurol. Med. Chir.(Tokyo)

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A 57-year-old female presented with a left putaminal hemorrhage, intraventricular hematoma (IVH), and acute obstructive hydrocephalus. Neuroendoscopic surgery was performed for the IVH. Three days after successful IVH removal and improvement of her consciousness, the patient lapsed into a comatose state due to hydrocephalus caused by obstruction of the mesencephalic aqueduct by a small remnant clot. The small clot was identified by constructive interference with steady state magnetic resonance imaging and was removed during a second-look operation. Even after the cerebrospinal fluid circulation improves following neuroendoscopic surgery for IVH, the patient may nevertheless develop a lifethreatening condition without warning signs in the subacute phase. Awareness of this complication will lead to early diagnosis and correct management.

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Complications following endoscopic intracranial procedures in children

Cited by 96 publications

References 41 publications

Comparison of Intracranial Neuroendoscopic Procedures in Children versus Adults

Comparison of Intracranial Neuroendoscopic Procedures in Children versus Adults

Ventricular endoscopy in the pediatric population: review of indications

A Pitfall of Neuroendoscopic Intraventricular Hematoma Removal - Delayed Obstructive Hydrocephalus Caused by a Small Remnant Clot -Case Report-

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