Kaif Mohammad, Husain Mazhar, Ojha Bal Krishna
Dr. Ram Manohar Lohia Institute of Medical Sciences, Department of Neurosurgery, Lucknow, India.
Turk Neurosurg. 2019;29(1):59-65. doi: 10.5137/1019-5149.JTN.21389-17.3.
To evaluate the technique and outcome of endoscopic management of intraventricular neurocysticercosis (NCC).
We retrospectively analysed the records of 30 consecutive patients of intraventricular (intra-third and fourth ventricle) NCC who underwent endoscopic management. The clinical profiles of the patients were evaluated which included age, symptoms and signs. Transcranial endoscopy was performed through a frontal burr hole using a Gaab Universal Endoscope system with rigid 0° and 30° telescope for endoscopic third ventriculostomy and removal of the cyst was described. The mean follow-up period was 22.6 months.
In 86.67% (26/30) patients we are able to visualize/excise/decompress the cyst. We were able to successfully excise all the third ventricular cysts (16/16) and in 66.67% (8/12) of the fourth ventricular cysts. In 90% (27/30) patients we were able to successfully divert the CSF flow and achieve long-term shunt free period.
We found that endoscopic cerebrospinal fluid (CSF) diversion in cases of intraventricular NCC is feasible and associated with high success rate. Endoscopic CSF diversion in NCC related hydrocephalus usually produces a long-term cure.
评估脑室内神经囊尾蚴病(NCC)的内镜治疗技术及效果。
我们回顾性分析了30例连续接受内镜治疗的脑室内(第三和第四脑室内)NCC患者的记录。评估了患者的临床资料,包括年龄、症状和体征。描述了经额骨钻孔使用带有刚性0°和30°望远镜的加布通用内镜系统进行经颅内镜检查,用于内镜下第三脑室造瘘术及囊肿切除。平均随访期为22.6个月。
在86.67%(26/30)的患者中,我们能够观察到/切除/减压囊肿。我们成功切除了所有第三脑室内的囊肿(16/16),以及66.67%(8/12)的第四脑室内囊肿。在90%(27/30)的患者中,我们成功地使脑脊液流动改道,并实现了长期无需分流期。
我们发现,脑室内NCC病例的内镜下脑脊液(CSF)分流是可行的,且成功率高。NCC相关脑积水的内镜下CSF分流通常能实现长期治愈。