Multiloculated Hydrocephalus

Spennato, Pietro; Cinalli, Giuseppe; Carannante, Giuseppe; Ruggiero, Claudio; de, María

doi:10.1007/978-88-470-2121-1_16

Cited by 17 publications

(32 citation statements)

References 65 publications

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“…Regardless of the precise mechanism, the disease often progresses toward Medical progress in understanding and treating MLH has long been hampered by a lack of commonly accepted terms. In an effort to resolve this problem, Spennato et al proposed a classification scheme for varieties of loculated hydrocephalus defined by the number and location of loculations [22]. In their 2012 paper, Andresen and Juhler proposed that the classification should be modified to be based on CSF absorption physiology as well as anatomy [2].…”

Section: Discussionmentioning

confidence: 99%

“…While its pathogenesis is poorly understood, MLH is known to arise primarily in individuals who have experienced neonatal meningitis [1,8], ventriculitis from shunt infection [7], or intraventricular hemorrhage of prematurity [5,7]. While multiple classification schemes have been created for MLH based on anatomical and physiological parameters, a unified system of discrete terminologies with prognostic value has not yet been created [2,22]. In practice, each MLH patient possesses uniquely complicated anatomy and CSF hydrodynamics and still requires individualized and often creative management [24].…”

Section: Introductionmentioning

confidence: 99%

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Surgical management of complex multiloculated hydrocephalus in infants and children

et al. 2014

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Both open and endoscopic fenestration appeared effective at improving shunt management. The endoscopic technique may offer advantages in operative time, blood loss, and length of hospital stay. These data suggest that endoscopic fenestration may be used as the initial approach for treatment of multiloculated hydrocephalus, with craniotomy and open fenestration used for more severe or refractory cases.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Surgical management of complex multiloculated hydrocephalus in infants and children

et al. 2014

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“…The occlusion of the aqueduct is largely irreversible and is thought to be associated with overdrainage of the supratentorial shunt. 19,25,33 While the neurosurgical treatment armamentarium has broadened to include open surgery, CSF diversion, and endoscopic techniques, serious complications ranging from cranial nerve to brainstem dys- function as well as a high rate of failure often hinder a complete cure. 1,3,5,14,20,36 In the present series, the 3 surgical patients all required multiple revision surgeries after fourth ventricular shunt placement.…”

Section: Discussionmentioning

confidence: 99%

Frequency and long-term follow-up of trapped fourth ventricle following neonatal posthemorrhagic hydrocephalus

Pomeraniec

Ksendzovsky

Ellis

et al. 2016

PED

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OBJECTIVE Intraventricular hemorrhage (IVH) is a common complication of premature neonates with small birth weight, which often leads to hydrocephalus and treatment with ventriculoperitoneal (VP) shunting procedures. Trapped fourth ventricle (TFV) can be a devastating consequence of the subsequent occlusion of the cerebral aqueduct and foramina of Luschka and Magendie. METHODS The authors retrospectively reviewed 8 consecutive cases involving pediatric patients with TFV following VP shunting for IVH due to prematurity between 2003 and 2012. The patients ranged in gestational age from 23.0 to 32.0 weeks, with an average age at first shunting procedure of 6.1 weeks (range 3.1–12.7 weeks). Three patients were managed with surgery. Patients received long-term radiographic (mean 7.1 years; range 3.4–12.2 years) and clinical (mean 7.8 years; range 4.6–12.2 years) follow-up. RESULTS The frequency of TFV following VP shunting for neonatal posthemorrhagic hydrocephalus was found to be 15.4%. Three (37.5%) patients presented with symptoms of posterior fossa compression and were treated surgically. All of these patients showed signs of radiographic improvement with stable or improved clinical examinations during postoperative follow-up. Of the 5 patients treated conservatively, 80% experienced stable ventricular size and 1 patient experienced a slight increase (3 mm) on imaging. All of the nonsurgical patients showed stable to improved clinical examinations over the follow-up period. CONCLUSIONS The frequency of TFV among premature IVH patients is relatively high. Most patients with TFV are asymptomatic at presentation and can be managed without surgery. Symptomatic patients may be treated surgically for decompression of the fourth ventricle.

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“…8 The most commonly described treatments are the placement of a shunt in the fourth ventricle through the aqueduct or foramen of Magendie, aqueductoplasty, fenestration of the outlets, or readjustment of overdrainage (where the cause is overdrainage of the supratentorial shunt). 1,5,15,21,22 Transcerebellar, transtentorial, and transtentorial hiatus routes are equally well described.…”

Section: Discussionmentioning

confidence: 99%

The marionette technique for treatment of isolated fourth ventricle

Longatti

Marton²,

Magrini³

2013

PED

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Isolated fourth ventricle is not uncommon in complex posthemorrhagic or postinfectious hydrocephalus. When the condition is symptomatic, the current surgical treatment is endoscopic aqueductoplasty, followed by endoscope-assisted placement of a catheter in the fourth ventricle. The authors suggest a very simple method of steering the tip of standard ventricular catheters by using materials commonly available in all operating rooms. The main advantage of this method is that it permits less invasive transaqueductal drainage of trapped fourth ventricles, especially in cases of narrow third ventricle, because the scope and catheter are introduced in sequence and not in a double-barreled fashion. Two illustrative cases are reported.

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Multiloculated Hydrocephalus

Cited by 17 publications

References 65 publications

Surgical management of complex multiloculated hydrocephalus in infants and children

Surgical management of complex multiloculated hydrocephalus in infants and children

Frequency and long-term follow-up of trapped fourth ventricle following neonatal posthemorrhagic hydrocephalus

The marionette technique for treatment of isolated fourth ventricle

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