Third ventricle floor variations and abnormalities in myelomeningocele associated hydrocephalus: an experience in 455 endoscopic third ventriculostomy procedures

Etüş, Volkan; Guler, Tugba Morali; Karabağlı, Hakan

doi:10.5137/1019-5149.jtn.18706-16.1

Cited by 17 publications

(11 citation statements)

References 11 publications

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“…In particular, the presence of septations and abnormal veins inside the third ventricle, or a second arachnoidal membrane under the floor of the third ventricle, might be in relation with embryonic development alterations with abnormal degrees of hypothalamus fusion. Etus et al (2016) recently confirmed these findings in a large multicenter series of spina bifida children. Variations and abnormalities of the third ventricular floor were documented in 41.1% of 455 children with myelomeningocele associated hydrocephalus.…”

Section: Access and Endoscopic View Of The Third Ventriclesupporting

confidence: 65%

Endoscopic Third Ventriculostomy: Technique

Tamburrini¹

2017

Textbook of Pediatric Neurosurgery

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Section: Access and Endoscopic View Of The Third Ventriclesupporting

confidence: 65%

Endoscopic Third Ventriculostomy: Technique

Tamburrini¹

2017

Textbook of Pediatric Neurosurgery

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“…Therefore, the risk of damage to the BA and the small arteries of the TC is also thought to be higher as they are often not visible through the opaque floor (18 (18,33). Another study, Etus et al found 33.1% thickened membrane between 455 meningomyelocele patient who were performed ETV (10). In our study, 13 patients (46.7%) had a thickened membrane such that the BA could not be visualised.…”

Section: █ Resultsmentioning

confidence: 52%

Marking basilar artery using neuronavigation during endoscopic third ventriculostomy: a clinical study

Özgüral

Kahiloğulları²,

Cinalli³

et al. 2019

Turkish Neurosurgery

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AIM: To evaluate the efficacy of using a neuronavigation system for demonstrating the relationship between the basilar artery (BA) and ventricular floor during endoscopic third ventriculostomy (ETV). MATERIAL and METHODS: Records of 28 patients (16 females and 12 males) diagnosed with obstructive hydrocephalus who had undergone a neuroendoscopic procedure were retrospectively examined. Patient age ranged from 1 to 76 years (median 24.46 years). The BA was marked with using the neuronavigation system in all cases to visualise its relationship to the floor of the third ventricle in real time. RESULTS: ETV was successfully performed in 28 patients with obstructive hydrocephalus. Of these, 13 (46.4%) patients had a thickened tuber cinereum (TC) membrane and 3 (10.7%) showed lateralization of the BA under the ventricular floor. No contact with the BA or related complications (e.g., major bleeding) was encountered with BA marking by using neuronavigation. CONCLUSION: Even though thickening of the TC membrane and/or displacement of the BA might be seen otherwise, we describe a new method that combines marking the BA and using neuronavigation to provide greater safety in the area where the ventriculostomy will be performed. This permits clearer orientation for the surgeon which significantly contributes to minimizing surgical morbidity.

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“…Chiari II malformation-related MI thickening may be the bestknown disease-associated condition. 18 Yamasaki et al 19 found MI thickening in all 6 patients with X-linked hydrocephalus examined by MR imaging. Loss of function L1 cell adhesion molecule (L1CAM) gene defects seems to result in the most severe neuroimaging phenotype, with 100% prevalence of MI thickening.…”

Section: Discussionmentioning

confidence: 99%

“…16,17 MI abnormalities can also occur in association with Chiari II malformation, X-linked hydrocephalus, Cornelia de Lange syndrome, and diencephalic-mesencephalic junction dysplasia, among others. [18][19][20][21][22] The thalamic massa intermedia has never been formally evaluated in a group of exclusively pediatric patients, to our knowledge. We have observed that the MI is commonly absent, small, thickened, and/or displaced in patients with additional midline abnormalities.…”

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confidence: 99%

Thalamic Massa Intermedia in Children with and without Midline Brain Malformations

Whitehead

Najim

2020

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:The massa intermedia is a normal midline transventricular thalamic connection. Massa intermedia aberrations are common in schizophrenia, Chiari II malformation, X-linked hydrocephalus, Cornelia de Lange syndrome, and diencephalic-mesencephalic junction dysplasia, among others. We have noticed that massa intermedia abnormalities often accompany other midline malformations. The massa intermedia has never been formally evaluated in a group of exclusively pediatric patients, to our knowledge. We sought to compare and contrast the prevalence, size, and location of the massa intermedia in pediatric patients with and without congenital midline brain abnormalities.MATERIALS AND METHODS: Successive 3T brain MR imaging examinations from pediatric patients with and without midline malformations were procured from the imaging data base at a pediatric hospital. Massa intermedia presence, size, morphology, and position were determined using 3D-TIWI with 1-mm isotropic resolution. The brain commissures, septum pellucidum, hypothalamus, hippocampus, vermis, and brain stem were evaluated to determine whether alterations were related to or predictive of massa intermedia abnormalities. RESULTS:The massa intermedia was more frequently absent, dysmorphic, and/or displaced in patients with additional midline abnormalities than in those without. The massa intermedia was absent in 40% of patients with midline malformations versus 12% of patients with normal findings (P , .001). Massa intermedia absence, surface area, and morphology were predictable by various attributes and alterations of the commissures, hippocampus, hypothalamus, vermis, brain stem, and third ventricle. CONCLUSIONS:Most pediatric patients have a thalamic massa intermedia centered in the anterior/superior third ventricle. Massa intermedia abnormalities are commonly associated with other midline malformations. Normal-variant massa intermedia absence is a diagnosis of exclusion.

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Third ventricle floor variations and abnormalities in myelomeningocele associated hydrocephalus: an experience in 455 endoscopic third ventriculostomy procedures

Cited by 17 publications

References 11 publications

Endoscopic Third Ventriculostomy: Technique

Endoscopic Third Ventriculostomy: Technique

Marking basilar artery using neuronavigation during endoscopic third ventriculostomy: a clinical study

Thalamic Massa Intermedia in Children with and without Midline Brain Malformations

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