Ventricular anatomy of hydrocephalus associated with myeloschisis and endoscopic third ventriculostomy.
OBJECTIVE
To characterize the anatomical features of the ventricular regions in patients with myeloschisis and related to successful performance of endoscopic third ventriculostomy (ETV).


METHODS
Radiological and endoscopic findings of 21 myeloschisis patients were retrospectively reviewed. Radiological features that could interfere with endoscopic procedures were (1) a huge massa intermedia (12/19), (2) sloping of the third ventricular floor (3/10), (3) narrow anteroposterior length of the third ventricular floor (2/10), and (4) narrow prepontine cistern (8/21). Endoscopic findings were (a) a narrow foramen of Monro (0/3), (b) hypertrophy of the anterior commissure (1/3), (c) sloping of the third ventricle floor (1/3), (d) a huge massa intermedia (3/3), and (e) opaque third ventricular floor (3/3). These endoscopic findings did not interfere with endoscopic procedures by using the Oi-HandyPro neuroendoscope without the above-mentioned radiological features 3 or 4.


CONCLUSIONS
Narrow anteroposterior length of the third ventricular floor and narrow prepontine cistern are not infrequently observed. Preoperative evaluation and intraoperative inspection of these findings are very important in successful performance of ETV.
Mori
Hiroshi
H
Division of Pediatric Neurosurgery, Jikei University Women's and Children's Medical Center, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo 105-8461, Japan. hmori@jikei.ac.jp
Oi
Shizuo
S
Nonaka
Yuichiro
Y
Tamogami
Ryo
R
Muroi
Ai
A
D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000473:pathology / Q000601:surgery; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D044583:Neuroendoscopy / Q000379:methods*; D055728:Primary Myelofibrosis / Q000150:complications / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D020542:Third Ventricle / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D014696:Ventriculostomy / Q000379:methods*