A new method for transcutaneous coaxial neuroendoscopy

Abstract

A new method of direct endoscopy of the subarachnoid space and a major part of the ventricles of the human central nervous system is presented. The technique was developed on more than 100 human bodies with the help of a bronchoscope. Percutaneous entry into the subarachnoidal space is performed from the dorsal side between vertebrae L5 and S1. The endoscope can be moved along the spinal cord on both the dorsal and the ventral side. From the dorsal side of spinal cord the cerebello-medullary cistern can be reached. The fourth ventricle is entered through the median aperture and then the third ventricle through the cerebral aqueduct. From the ventral side of the spinal cord the posterior cranial fossa is reached and the large arteries and the cranial nerves can be inspected. The main conclusion of the present report is that the subarachnoid space seems to be large enough for a coaxial exploration with a 3–5 mm diameter fibroscope if the investigator possesses a good knowledge of the subarachnoid anatomy. The technique provides new approaches in research and possibilities of clinical investigations and therapy.