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Endoscopic surgical anatomy of the paediatric third ventricle studied using virtual neuroendoscopy based on 3-D ultrasonography

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Abstract

Introduction

Endoscopic treatment for occlusive hydrocephalus requires knowledge of individual ventricular and vascular anatomies of the ventricular system.

Methods

We studied the feasibility of virtual neuroendoscopy (VNE) based on 3-D ultrasonography (3-D US) for the identification of parenchymal and vascular anatomical landmarks of the third ventricle and its impact on the surgical planning of endoscopic third ventriculostomy (ETV) in paediatric patients. 3-D US was performed through the anterior fontanel in four infants with hydrocephalus.

Results

Virtual neuroendoscopy revealed the size of the foramen of Monro, anatomical landmarks of the floor of the third ventricle crucial for correct fenestration during ETV, but not the premesencephalic cistern. The basilar bifurcation was identified in relation to the floor of the third ventricle by VNE (power-Doppler ultrasonography) and confirmed intraoperatively after ETV.

Conclusion

3-D US-based VNE reveals detailed anatomical information on the ventricular system including the foramen of Monro and the floor of the third ventricle. Within the premesencephalic cistern vascular anatomy can be visualized, but not non-vascular structures.

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Authors and Affiliations

  1. Department of Neurosurgery, University Medical Centre, Justus Liebig University, Klinikstrasse 29, 35385, Giessen, Germany

    Andreas Jödicke, Wolfram Scharbrodt, Ilona Schroth & Dieter-Karsten Böker

  2. Department of Paediatric Radiology, University Medical Centre, Justus Liebig University, Feulgenstrasse 12, 35385, Giessen, Germany

    L. Daniel Berthold

  3. Department of Neonatology, University Medical Centre, Justus Liebig University, Feulgenstrasse 12, 35385, Giessen, Germany

    Irwin Reiss

  4. Department of Paediatric Neurology, University Medical Centre, Justus Liebig University, Feulgenstrasse 12, 35385, Giessen, Germany

    Bernd A. Neubauer

Authors
  1. Andreas Jödicke
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  2. L. Daniel Berthold
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  3. Wolfram Scharbrodt
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  4. Ilona Schroth
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  5. Irwin Reiss
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  6. Bernd A. Neubauer
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  7. Dieter-Karsten Böker
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Corresponding author

Correspondence to Andreas Jödicke.

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The authors have no financial interest in the systems used in this study

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Jödicke, A., Berthold, L.D., Scharbrodt, W. et al. Endoscopic surgical anatomy of the paediatric third ventricle studied using virtual neuroendoscopy based on 3-D ultrasonography. Childs Nerv Syst 19, 325–331 (2003). https://doi.org/10.1007/s00381-003-0748-7

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  • DOI: https://doi.org/10.1007/s00381-003-0748-7

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