Manual Occipital Ventricular Puncture for Cerebrospinal Fluid Shunt Surgery : Can Aiming Be Standardized?
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概要
- 論文の詳細を見る
The manual occipital ventricular puncture is a standard surgical procedure, but specific targeting has not received sufficient attention despite the experience of anatomical disorientation. This study tried to identify an exact site for the ideal trajectory with this method, especially in the sagittal plane, which avoids contact with the choroid plexus that may be the major source of complications. A total of 44 consecutive adult cases undergoing cerebrospinal fluid shunting through the occipital route for hydrocephalus were retrospectively reviewed for the following: correlations between burr hole site, direction of puncture, and location of the ventricular catheter based on postsurgical radiological studies; calculation of the ideal trajectory to place the catheter tip in the anterior horn of the lateral ventricle without contact with the choroid plexus through the standard occipital burr hole. In addition, the relationships between the location of the ventricular structure, the cranial base line connecting the nasion and inion, and the size of the ventricle were evaluated. Incorrect catheter emplacement was found in five cases, which suggested that this procedure using the standard burr hole site and aim point might result in incorrect catheter placement. The ideal external aim points were widely distributed because of the variable heights of ventricular structures from the cranial baseline. No correlation between the locations of the anatomical points and ventricular size was found. The present study could not define a standard external aim point. Tailored preoperative planning of the trajectory is recommended.
- 日本脳神経外科学会の論文
- 2004-07-15
著者
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SHIMIZU Satoru
Departments of Neurosurgery Kitasato University School of Medicine
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FUJII Kiyotaka
Departments of Neurosurgery Kitasato University School of Medicine
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Shimizu Satoru
Department Of Neurosurgery Kitasato University School Of Medicine
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Fujii Kiyotaka
北里大学 医学部脳神経外科
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Fujii Kiyotaka
Kitasato Univ. School Of Medicine
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TANAKA Ryusui
Department of Neurosurgery,Kitasato University School of Medicine,Sagamihara,Kanagawa
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IIDA Hideo
Department of Neurosurgery, International Goodwill Hospital
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Iida Hideo
Department Of Dermatology (unit Of Plastic Surgery) Tokyo Medical And Dental University School Of Me
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Fujii Kiyotaka
Department Of Brain Sugery School Of Medicine Kitasato University
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Suzuki Sachio
Department Of Neurosurgery Kitasato University School Of Medicine
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Tanaka Ryusui
Department Of Neurosurgery Kitasato University School Of Medicine Sagamihara Kanagawa
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Tanaka Ryusui
Department Of Neurosurgery Kitasato University School Of Medicine
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Shimizu Satoru
Department Of Neurosurgery Yokohama Stroke And Brain Center
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Zhang Yazhuo
Department Of Neurosurgery Beijing Neurosurgical Institute
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Ducati Alessandro
Ordinario Di Neurochirurgia Universita' Di Torino
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Shimizu Satoru
Department Of Hygiene And Public Health I Tokyo Women's Medical University
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Shimizu Satoru
Kitasato Univ. School Of Medicine Kanagawa Jpn
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Shimizu Satoru
Department Of Biotechnology Faculty Of Engineering Kyoto Sangyo University
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FIRSCHING Raimund
Klinik fur Neurochirurgie Otto-von-Guericke-Universitat
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Firsching Raimund
Klinik Fur Neurochirurgie Der Otto-von-guericke-universitat
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TANAKA Ryusui
Department of Neurosurgery, Kitasato University School of Medicine
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