Endoscopic Anatomy of the Ventricles

Abstract

Dilated ventricular cavities are particularly suitable for neurosurgical endoscopy. Although purely diagnostic endoscopy is no longer particularly useful due to progress in medical imaging, especially MRI, this technique is still very useful for certain precise procedures optimally and most safely performed under visual control [1]. The main indication for neurosurgical endoscopy remains ventriculocisternostomy for the treatment of obstructive hydrocephalus. The other indications are much more limited due to the small number of cases to be treated, but include colloid cysts of the third ventricle or rare cases of biopsy of intraventricular lesions poorly accessible to stereotactic biopsy procedures. Intraventricular endoscopic navigation is facilitated by accurate guidance; in other words, the operator must always know where he is. It is therefore essential to have perfect knowledge of the intraventricular anatomy, in order at all times to recognize the part of the ventricular system in which the endoscope is situated and clearly identify the anatomical structures and outlines encountered [6].