title: Endoscopic transtentorial ventriculocystostomy and cystoventriculoperitoneal shunt in a neonate with Dandy-Walker malformation and associated aqueductal obstruction.
abstract: OBJECTIVE
  Shunting of the lateral ventricle and the posterior fossa cyst is the advocated surgical therapy for children with Dandy-Walker malformation (DWM) and associated aqueductal obstruction. The high rate of complications of combined shunting stimulated the authors to search for an alternative surgical solution.
  After transtentorial endoscopic ventriculocystostomy, a cystoventricular catheter, connected to a peritoneal shunt, was placed in a neonate with DWM and associated aqueductal obstruction. Immediately prior to ventriculocystostomy, the presence of a blocked third ventricular outflow was reconfirmed by contrast medium injection. Neuronavigation was required to define the surgical path from the lateral ventricle through the tentorium and the overlying small rim of brain parenchyma into the posterior fossa cyst. The postoperative clinical course was uneventful with radiologically proven reduction of the size of the ventricular system and the cyst.
  
  
  CONCLUSIONS
  Cystoventriculoperitoneal shunt placement after transtentorial endoscopic ventriculostomy is a surgical alternative in very young children with DWM and associated aqueductal obstruction.
authors.affiliation: Department of Neurosurgery, RWTH Aachen, Aachen, Germany. Weinzierl2@post.rwth-aachen.de
authors.forename: Martin R
authors.initials: MR
authors.lastname: Weinzierl
authors.forename: Volker A
authors.initials: VA
authors.lastname: Coenen
authors.forename: Marcus C
authors.initials: MC
authors.lastname: Korinth
authors.forename: Joachim M
authors.initials: JM
authors.lastname: Gilsbach
authors.forename: Veit
authors.initials: V
authors.lastname: Rohde
mesh_terms: D002535:Cerebral Aqueduct / Q000601:surgery*; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D003616:Dandy-Walker Syndrome / Q000150:complications / Q000601:surgery*; D004388:Dura Mater / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D044583:Neuroendoscopy; D017287:Ventriculoperitoneal Shunt / Q000379:methods*; D014696:Ventriculostomy