Comparative Analysis of Cerebrospinal Fluid Dynamics in the Ventriculo-Cisternal Fluid Pathway and Shunt-independent Arrested Hydrocephalus after Neuroendoscopic Ventriculostomy

在内窥镜手术前后，通过心脏门控电影模式磁共振成像（MRI）描绘了个体特定病理生理学中的脑脊液（XSF）动力学特征。神经内镜手术用于治疗具有特定病理生理学的各种形式的脑积水患者，包括成年期长期明显脑室扩大（LOVA）、孤立性单侧脑积水（IUH）、孤立性IV室（IFV）、不成比例的大IV室（DLFV）、孤立性菱形脑室（IRV）、孤立性四脑室扩大（IQV），这些手术包括III脑室吻合术、经头、尾侧入路的导水管成形术、Monro孔/Magendie孔成形术、中隔吻合术、IV脑室吻合术、脑室分隔开孔蛛网膜囊肿或囊性肿瘤开孔阻塞脑室伴或 关于我们 无肿瘤切除和背侧脑室吻合术脑室扩大的术后变化复杂，反映了脑实质顺应性和主要CSF通路的术后校正CSF流动动力学的差异。有出血或感染病史的梗阻性脑积水患者可能是ETV的良好候选者，其安全性和成功率与更一般的患者系列相当。出血和感染并存的患者不适合ETV治疗，除非是作为最后的治疗手段。在出血后曾接受分流术的患者中，ETV非常成功。对于原发性导水管狭窄的患者，即使是有出血或CSF感染史的患者，也是非常成功的。结果发现，通过打开脑室隔离可以达到手术目的，即形成脑积水停止状态，但并不总是通过与脑池连通来实现，尤其是在婴儿中。这可能是由于婴儿蛛网膜下腔CSF动力学不成熟所致。术前和术后电影MRI是评估主要CSF通路CSF动力学的一种非常有用的方法。少

The characteristics of the cerebrospmal fluid (XSF) dynamics in the individual specific pathophysiologies were delineated by cardiac-gated cine-mode magnetic resonance imaging (MRI) before and after the endoscopic procedure. Neuroendoscopic surgery was used tp treat patients with various forms of hydrocephalus with specific pathophysiology, including long-standing overt ventriculomegaly in adulthood (LOVA), isolated unilateral hydrocephalus (IUH), isolated IV ventricle (IFV), disproportionately large IV ventricle (DLFV), isolated rhombencephahc ventricle (IRV) isolated quarto-ventriculomegaly (IQV), dorsal sac in holoprosencephaly (DS) and loculated ventricle (LV).These procedures included III ventnculostomy, aqueductal plasty by both rostral and caudal approaches, foraminal plasty in the foramen of Monro/foramen of Magendie, septostomy, IV ventnculostomy, fenestration of septation in the loculated ventricle fenestration of arachnoid cyst or cystic tumor obstructing a ventricle with or … More without tumor removal and dorsal sac ventnculostomy The postoperative changes of ventriculomegaly were complicated, reflecting the differences in the brain parenchymal compliance and postoperatively corrected CSF flow dynamijcs in the major CSF pathway. Patients with obstructive hydrocephalus and a history of either hemorrhage or infection may be good candidates for ETV with safety and success rates comparable with those in more general series of patients. Patients who have sustained both hemorrhage and infection are poor candidates for ETV, except m selected cases and as a treatment of last resort. In patients who have previously undergone shunt placement posthemorrhage, ETV is highly successful. It is also highly successful m patients with primary aqueductal stenosis even in those with a history of hemorrhage or CSF infection. It was found that the operative goal creating the state of arrested hydrocephalus, could be obtained by opening the ventricular isolation but not always by achieving communication with the cisterns especially in infants. This may be due to the immaturity of the subarachnoid CSF dynamics in the infants. Pre-and postoperative cine-mode MRI is a very useful ijiethod of estimating the CSF dynamics in the major CSF pathway. Less