Eguchi Seiichiro, Aihara Yasuo, Tsuzuki Shunsuke, Omura Yoshihiro, Kawamata Takakazu, Okada Yoshikazu
Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
Childs Nerv Syst. 2014 Mar;30(3):515-9. doi: 10.1007/s00381-014-2365-z. Epub 2014 Jan 28.
Endoscopic third ventriculostomy (ETV) is a simplified treatment relative to shunting for several types of hydrocephalus. The fatal complication of ETV is intraoperative hemorrhage due to arterial injury of the basilar artery, posterior cerebral arteries, and their perforators.
Here, we present a modified technique of ETV by using a transendoscopic pulse-waved microvascular Doppler probe and videoscope head to avoid vascular injury behind the tuber cinereum (TC). The microvascular Doppler probe can detect the basilar artery complex through the TC.
Ventriculostomy with the probe head helps prevent vascular injury by informing the presence of invisible vessels under endoscopic view during perforation, and the method introduced here is certain to prove invaluable for enhancing the safety of ETV.
相对于几种类型脑积水的分流术，内镜下第三脑室造瘘术（ETV）是一种简化的治疗方法。ETV的致命并发症是由于基底动脉、大脑后动脉及其穿支动脉损伤导致的术中出血。
在此，我们介绍一种改良的ETV技术，通过使用经内镜脉冲波微血管多普勒探头和视频镜头来避免灰结节（TC）后方的血管损伤。微血管多普勒探头可通过TC检测基底动脉复合体。
使用探头进行脑室造瘘术有助于在穿孔过程中通过告知内镜视野下不可见血管的存在来预防血管损伤，并且此处介绍的方法对于提高ETV的安全性肯定具有极高价值。
