title: Endoscopic neurosurgery in preterm and term newborn infants--a feasibility report.
abstract: OBJECTIVE
  Neuroendoscopic procedures became essential in neurosurgical treatment of disturbed cerebrospinal fluid dynamics. While a vast number of papers report on the neuroendoscopic experience for adults and children, no series so far reported on techniques and indications for neonate infants. We present our experience for the feasibility of neuroendoscopic procedures in preterm and term newborn infants.
  
  
  METHODS
  All preterm and term infants who underwent an endoscopic neurosurgical intervention prior to the 28th day after the previously estimated date of delivery were identified by retrospective review. Surgical procedures and techniques, complications, and further follow-up data are reported.
  
  
  RESULTS
  During the study period, 14 infants (median age at surgery, 36+(2)/7 weeks of gestation) underwent 20 endoscopic procedures. The performed procedures included endoscopic septostomy (n = 3), endoscopic shunt placement for multiloculated hydrocephalus (n = 4), endoscopic transaqueductal stenting for isolated fourth ventricle (n = 3), and endoscopic lavage for ventriculitis (n = 4) or for intraventricular hemorrhage (n = 6). No severe complications were seen, while two patients necessitating unexpected interventions during further follow-up (10 %).
  
  
  CONCLUSIONS
  Despite the fragility of preterm and term newborn infants, neuroendoscopic procedures may play an important role in the treatment of disturbed cerebrospinal fluid (CSF) dynamics also in this patient population. The neuroendoscopic approach may be curative in conditions like isolated lateral ventricle, may facilitate simplified and effective CSF diversion in multiloculated hydrocephalus or isolated fourth ventricle, and may be beneficial in the course of ventriculitis and intraventricular hemorrhage. Further studies must verify our experience with a bigger cohort of patients and on a multicenter basis.
authors.affiliation: Department of Pediatric Neurosurgery, Charité University Medical Center, Berlin, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Schulz
authors.forename: Christoph
authors.initials: C
authors.lastname: Bührer
authors.forename: Birgit
authors.initials: B
authors.lastname: Spors
authors.forename: Hannes
authors.initials: H
authors.lastname: Haberl
authors.forename: Ulrich-Wilhelm
authors.initials: UW
authors.lastname: Thomale
mesh_terms: D001927:Brain Diseases / Q000601:surgery*; D002543:Cerebral Hemorrhage / Q000601:surgery; D058565:Cerebral Ventriculitis / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000601:surgery*; D007234:Infant, Premature; D008297:Male; D044583:Neuroendoscopy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D016896:Treatment Outcome