Third Ventriculostomy by Puncture of the Lamina Terminalis and the Floor of Third Ventricle

Scarff, John E.

doi:10.3171/jns.1966.24.5.0935

Cited by 39 publications

(13 citation statements)

References 4 publications

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“…Scarff [16]has reported that closure of the punctures made through the floor of the third ventricle by tissue growth is frequent in infants. However, it is unusual in adults.…”

Section: Discussionmentioning

confidence: 99%

“…However, in certain forms of noncommunicating hydrocephalus, mechanical obstructions, infections and overdrainage are avoidable if a communication between the inner and the outer CSF spaces instead of a shunting procedure is performed by perforating the floor of the third ventricle by endoscopic techniques [6, 7, 8, 9, 10, 11, 13, 14, 15]or open craniotomy [1, 2, 3, 4, 5, 12, 16]. The infection rates of the CSF vary from 2 to 30% [10, 17].…”

Section: Discussionmentioning

confidence: 99%

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Failure of Open Third Ventriculostomy for Shunt Infections in Infants

Akdemir

Kurtsoy²,

Oktem³

et al. 1999

Pediatr Neurosurg

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Open third ventriculostomy (OTV) was performed on 4 infants with noncommunicating hydrocephalus and intractable shunt infections. All patients were resistant or relapsed after treatment with intravenous and intraventricular antibiotics along with change of the shunt apparatus. We performed phase-contrast cine magnetic resonance imaging (MRI) for preoperative and postoperative evaluation of cerebrospinal fluid (CSF) flow at the aqueduct of Sylvius. All patients required a second OTV approximately 3 weeks after the first OTV due to closure of the patency. Our experience led us to view OTV as an unsuccessful procedure in infantile noncommunicating hydrocephalus due to an insufficiently developed subarachnoid space. The patients’ data, operative findings and probable causes of failure are presented here.

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“…Scarff [16]has reported that closure of the punctures made through the floor of the third ventricle by tissue growth is frequent in infants. However, it is unusual in adults.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Failure of Open Third Ventriculostomy for Shunt Infections in Infants

Akdemir

Kurtsoy²,

Oktem³

et al. 1999

Pediatr Neurosurg

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“…Scarff would continue to use this design for nearly 30 years, with the only modification being a conversion to a fiberoptic light in 1963. 13,22,23 William McNickle would make one of the final advancements in performing the third ventriculostomy in 1947, 14 before a period of relative silence that fell in concert with the arrival of valved shunts. 24 McNickle described a method of percutaneous ventricular puncture; more importantly, he noted that "In the past, third ventriculostomy has been reserved for cases of non-communicating hydrocephalus.… The division of hydrocephalus into communicating and non-communicating types is an arbitrary one, and has been over-emphasized."…”

Section: Intracranial Endoscopesmentioning

confidence: 99%

A lesson in history: the evolution of endoscopic third ventriculostomy

Schmitt¹,

Jane²

2012

FOC

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The history of endoscopic third ventriculostomy (ETV) demonstrates the importance of studying neurosurgery's history. A story that began with numerous technological advancements started to fizzle as neurosurgeons were stymied by problems encountered during the infancy of the technology they were still developing. The new technique, although sound in theory, failed to deliver a realistic solution for managing hydrocephalus; it lost the battle to the valved shunt. Over the last 15–20 years, a clearer understanding of pathophysiological mechanisms underlying various forms of hydrocephalus, along with effective implementation of evidence-based practice, has allowed for optimization of patient selection and a remarkable improvement in ETV success rates. Neurosurgeons would be wise to take the lessons learned in modernizing the ETV procedure and reassure themselves that these lessons do not apply to other methods that are tempting to dismiss as antiquated or archaic.

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“…Bypassing the normal course of flow within the ventricular system without leaving shunt hardware has been reported (Dandy, 1922;White, 1938;Voris, 1951;Scarff, 1966;Guiot, 1973). Third ventriculostomy via punctures through the lamina terminalis or floor of the third ventricle have been shown to be of use recently in certain cases of obstructive hydrocephalus or subarachnoid hemorrhage (Sindou 1994;Tomasello et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

Fenestration of the superior medullary velum as treatment for a trapped fourth ventricle: A feasibility study

Tubbs¹,

Salter²,

Oakes³

2004

Clinical Anatomy

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We developed a novel approach for fenestration of the trapped fourth ventricle utilizing the superior medullary velum (valve of Vieussens). Trapped fourth ventricles, which are seen often in the pediatric hydrocephalic population, are troublesome entities surgically. A right burr hole was carried out in 10 adult cadavers with no gross intracranial pathology and the superior medullary velum was fenestrated to the quadrigeminal cistern with the aid of an endoscope. This technique was carried out easily in all cadaveric specimens. With endoscopy, no vascular insult was appreciated either before or after fenestration of the superior medullary velum. These preliminary findings demonstrate that fenestration of the superior medullary velum may provide a good alternative to the present therapy of shunting trapped fourth ventricles, a therapy wrought with complications.

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Third Ventriculostomy by Puncture of the Lamina Terminalis and the Floor of Third Ventricle

Cited by 39 publications

References 4 publications

Failure of Open Third Ventriculostomy for Shunt Infections in Infants

Failure of Open Third Ventriculostomy for Shunt Infections in Infants

A lesson in history: the evolution of endoscopic third ventriculostomy

Fenestration of the superior medullary velum as treatment for a trapped fourth ventricle: A feasibility study

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