Ventricular catheter placement in children with hydrocephalus and small ventricles: the use of a frameless neuronavigation system

Gil, Ziv; Siomin, Vitaly; Beni‐Adani, Liana; Sira, Liat Ben; Constantini, Shlomi

doi:10.1007/s00381-001-0550-3

Cited by 56 publications

(41 citation statements)

References 11 publications

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“…Nevertheless, it appears that, as also exemplified in the present study, complications are less frequent in ventriculoperitoneal shunting than in lumboperitoneal shunting, in particular with a lower need for revision surgery during follow-up [17,18,19]. …”

Section: Discussionmentioning

confidence: 53%

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Shunt Surgery in Idiopathic Intracranial Hypertension Aided by Electromagnetic Navigation

Hermann¹,

Polemikos²,

Heissler³

et al. 2017

Stereotact Funct Neurosurg

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Background: Idiopathic intracranial hypertension (IIH) is characterized by increased cerebrospinal fluid (CSF) pressure and normal or slit ventricles. Lumboperitoneal shunting had been favored by many investigators for CSF diversion in IIH for decades; however, it has been associated with various side effects. Because of the small ventricular size adequate positioning of a ventricular catheter is challenging. Objectives: Here, we investigated the usefulness of electromagnetic (EM)-guided ventricular catheter placement for ventriculoperitoneal shunting in IIH. Methods: Eighteen patients with IIH were included in this study. The age of patients ranged from 5 to 58 years at the time of surgery (mean age: 31.8 years; median: 29 years). There were 2 children (5 and 11 years old) and 16 adults. Inclusion criteria for the study were an established clinical diagnosis of IIH, lack of improvement with medication, and the presence of small ventricles. In all patients EM-navigated placement of the ventricular catheter was performed using real-time tracking of the catheter tip for exact positioning close to the foramen of Monro. Postoperative CT scans were correlated with intraoperative screen shots to validate the position of the catheter. Results: In all patients EM-navigated ventricular catheter placement was achieved with a single pass. There were no intraoperative or postoperative complications. Postoperative imaging confirmed satisfactory positioning of the ventricular catheter. No proximal shunt failure was observed during the follow-up at a mean of 41.5 months (range: 7-90 months, median: 40.5 months). Conclusions: EM-navigated ventricular catheter placement in shunting for IIH is a safe and straightforward technique. It obviates the need for sharp head fixation, the head of the patient can be moved during surgery, and it may reduce the revision rate during follow-up.

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Section: Discussionmentioning

confidence: 53%

“…Both frame-based and frameless stereotactic techniques have been shown to be useful in the treatment of IIH [17,18,19] including robotic technology [20,21]. Electromagnetic (EM) navigation which can be performed without rigid head fixation has been used for various indications in neurosurgery [22,23,24,25,26,27,28].…”

Section: Introductionmentioning

confidence: 99%

Shunt Surgery in Idiopathic Intracranial Hypertension Aided by Electromagnetic Navigation

Hermann¹,

Polemikos²,

Heissler³

et al. 2017

Stereotact Funct Neurosurg

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“…In all three types the pathophysiology consists of increased venous sinus pressure, decreased absorption of spinal CSF, increased secretion of spinal CSF, increased brain blood flow and brain edema [14] , and therefore there is no clear distinction between the above three types of disease [15] . The primary mode of therapy for patients with PC accompanied by benign intracranial hypertension and idiopathic intracranial hypertension is removal of possible etiologic causes and drainage of CSF in cases where drug therapy is ineffective [4,12,[15][16][17] . Patients who have increased intracranial pressure due to obstructed venous sinus thrombosis are usually managed by administration of anticoagulants and thrombolytic medication [16,18] .…”

Section: Discussionmentioning

confidence: 99%

“…In pediatric patients with PC and high intracranial pressure it is often difficult to determine how to drain the CSF [17] . In patients with PC it has been suggested that in order to avoid brain injury due to the small size of the ventricles, CSF drainage should be conducted by an LP shunt rather than a VP shunt [5,7,8] .…”

Section: Discussionmentioning

confidence: 99%

Valve Pressure Upgrade May Produce Progressive Deterioration of Vision in Children with Slit Ventricle Syndrome

Park

Yoon²,

Cho³

et al. 2007

Pediatr Neurosurg

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underwent a lumboperitoneal shunt with low-pressure valve, which resulted in the disappearance of intermittent headaches and a deterioration of visual acuity. We suggest that valve pressure upgrade in children with slit ventricle syndrome after ventriculoperitoneal shunt for pseudotumor cerebri may produce acute deterioration of vision that had already been compromised, even within the normal intracranial pressure range and with improvement of associated symptoms.

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“…The authors found improved longevity of the shunt when combined with ETV. Gil et al 4 retrospectively evaluated ventricular catheter placement with a frameless optical navigation system, but their study included only 9 patients and was excluded for having a sample size smaller than 10. McMillen et al 10 used EM image guidance for a variety of conditions in children that included only 3 cases of hydrocephalus.…”

Section: Excluded Articlesmentioning

confidence: 99%

Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 3: Endoscopic computer-assisted electromagnetic navigation and ultrasonography as technical adjuvants for shunt placement

Flannery

Duhaime

Tamber

et al. 2014

PED

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Object This systematic review was undertaken to answer the following question: Do technical adjuvants such as ventricular endoscopic placement, computer-assisted electromagnetic guidance, or ultrasound guidance improve ventricular shunt function and survival? Methods The US National Library of Medicine PubMed/MEDLINE database and the Cochrane Database of Systematic Reviews were queried using MeSH headings and key words specifically chosen to identify published articles detailing the use of cerebrospinal fluid shunts for the treatment of pediatric hydrocephalus. Articles meeting specific criteria that had been delineated a priori were then examined, and data were abstracted and compiled in evidentiary tables. These data were then analyzed by the Pediatric Hydrocephalus Systematic Review and Evidence-Based Guidelines Task Force to consider evidence-based treatment recommendations. Results The search yielded 163 abstracts, which were screened for potential relevance to the application of technical adjuvants in shunt placement. Fourteen articles were selected for full-text review. One additional article was selected during a review of literature citations. Eight of these articles were included in the final recommendations concerning the use of endoscopy, ultrasonography, and electromagnetic image guidance during shunt placement, whereas the remaining articles were excluded due to poor evidence or lack of relevance. The evidence included 1 Class I, 1 Class II, and 6 Class III papers. An evidentiary table of relevant articles was created. Conclusions Recommendation: There is insufficient evidence to recommend the use of endoscopic guidance for routine ventricular catheter placement. Strength of Recommendation: Level I, high degree of clinical certainty. Recommendation: The routine use of ultrasound-assisted catheter placement is an option. Strength of Recommendation: Level III, unclear clinical certainty. Recommendation: The routine use of computer-assisted electromagnetic (EM) navigation is an option. Strength of Recommendation: Level III, unclear clinical certainty.

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Ventricular catheter placement in children with hydrocephalus and small ventricles: the use of a frameless neuronavigation system

Abstract: The usage of a neuronavigation system is safe and may be beneficial for optimal positioning and trajectory of ventricular catheters in children with small ventricles or an abnormal ventricular anatomy.

Cited by 56 publications

References 11 publications

Shunt Surgery in Idiopathic Intracranial Hypertension Aided by Electromagnetic Navigation

Shunt Surgery in Idiopathic Intracranial Hypertension Aided by Electromagnetic Navigation

Valve Pressure Upgrade May Produce Progressive Deterioration of Vision in Children with Slit Ventricle Syndrome

Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 3: Endoscopic computer-assisted electromagnetic navigation and ultrasonography as technical adjuvants for shunt placement

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