Journal Article10.1227/01.NEU.0000088810.75724.0E
Endoscopic Third Ventriculostomy with Cystoventricular Stent Placement in the Management of Dandy-Walker Malformation: Technical Case Report of Three Patients
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TL;DR: Cystoventricular stent placement with endoscopic third ventriculostomy is a promising alternative in patients with Dandy-Walker malformation with aqueductal obstruction.
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Abstract: OBJECTIVE AND IMPORTANCE: Dandy-Walker malformation has conventionally been managed with placement of cystoperitoneal or ventriculoperitoneal shunts. However, associated aqueductal obstruction requires simultaneous drainage of both the supratentorial and infratentorial compartments. CLINICAL PRESENTATION: Three children with Dandy-Walker malformation and aqueductal obstruction were managed with endoscopic third ventriculostomy and placement of a stent from the third ventricle to the posterior fossa cyst. INTERVENTION: After an endoscopic third ventriculostomy was performed, the stent was placed from the third ventricle to the posterior fossa cyst through the thinnest part of the posteroinferior wall of the aqueduct. There was no operative morbidity. In one patient, the stent was malpositioned, requiring a repositioning. The endoscopic third ventriculostomy was successful in two patients, whereas it failed in one, requiring a ventriculoperitoneal shunt placement. CONCLUSION: Cystoventricular stent placement with endoscopic third ventriculostomy is a promising alternative in patients with Dandy-Walker malformation with aqueductal obstruction.
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Citations
Endoscopic third ventriculostomy for obstructive hydrocephalus
Dieter Hellwig,Joachim Andreas Grotenhuis,Wuttipong Tirakotai,Thomas Riegel,Dirk Michael Schulte,B. L. Bauer,Helmut Bertalanffy +6 more
TL;DR: From the review of the publications since the first ETV performed by Mixter in 1923, this technique is the treatment of choice for obstructive hydrocephalus caused by different etiologies and is an alternative to cerebrospinal fluid shunt application.
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Late rapid deterioration after endoscopic third ventriculostomy: additional cases and review of the literature
James M. Drake,Paul Chumas,John R. W. Kestle,Alain Pierre-Kahn,Matthieu Vinchon,Jennifer Brown,Ian F. Pollack,Hajime Arai +7 more
TL;DR: Late rapid deterioration is a rare but lethal complication of ETV, and the mechanism is unclear, but deterioration can occur long after the ETV becomes occluded.
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Treatment options for Dandy-Walker malformation.
TL;DR: Endoscopic procedures may be considered an acceptable alternative in children with DWM and the authors propose a treatment protocol based on preoperative MR imaging findings of associated aqueductal stenosis.
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Hydrocephalus in Dandy-Walker malformation.
Pietro Spennato,Giuseppe Mirone,Anna Nastro,Maria Consiglio Buonocore,Claudio Ruggiero,Vincenzo Trischitta,Ferdinando Aliberti,Giuseppe Cinalli +7 more
TL;DR: The correct interpretation of the modern neuroradiologic techniques, including CSF flow MR imaging, may help in identifying a “real” Dandy–Walker malformation.
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Current state and future development of intracranial neuroendoscopic surgery.
Giuseppe Cinalli,Paolo Cappabianca,Raffaele de Falco,Pietro Spennato,Emilio Cianciulli,Luigi Maria Cavallo,Felice Esposito,Claudio Ruggiero,Giuseppe Maggi,Enrico de Divitiis +9 more
TL;DR: The three main chapters of neuroendoscopy (transventricular, endonasal transphenoidal and endoscope-assisted microsurgery) are reviewed, concerning operative instruments, surgical procedures, main indications and results.
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TL;DR: Unsatisfactory results following membrane excision in early cases, and observations of CSF dynamic disturbances confirm the futility of the direct approach for the management of the Dandy-Walker syndrome.
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Dandy-Walker Cyst Upward Herniation: The Role of Magnetic Resonance Imaging and Double Shunts
TL;DR: Two patients with upward transtentorial herniation of their Dandy-Walker cysts are presented to illustrate the diagnostic value of magnetic resonance (MR) imaging with the demonstration of unique 'keyhole' and 'snail' signs on the axial and sagittal MR images, respectively.
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CSF dynamics in Dandy-Walker syndrome.
Tunçalp Özgen,B Açikgöz +1 more
TL;DR: Three different types of the Dandy-Walker malformation are reported and the therapeutic possibilities are discussed, with the aim of avoiding or minimize the complications.
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Dandy-Walker malformation: etiologic heterogeneity and empiric recurrence risks.
TL;DR: The Dandy-Walker malformation (DWM) includes hydrocephalus, incomplete cerebellar vermis and a posterior fossa cyst as discussed by the authors, which represents marked genetic and etiologic heterogeneity.