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Volume 3
Journal of Neurology and Clinical Neuroscience
Neurosurgery 2019 & Neuroimmunology 2019
May 22-23, 2019
Neurosurgery and Neurological Surgeons
Neuroscience and Neuroimmunology
May 22-23, 2019 London, UK
6
th
Annual Meeting on
9
th
Global Summit on
&
J Neurol Clin Neurosci, Volume 3
Trajectory planning with the use of Image guidance System for Endoscopic third
ventriculostomy and its effect in reducing complications
M Samir Irfan Wasi
and
Salman Sharif
Liaquat National Hospital, Pakistan
Introduction:
Endoscopic third ventriculostomy (ETV) is commonly being performed by neurosurgeons around the world for
the management for hydrocephalus in adults and paediatric age group. Nevertheless, ETV has been associated with multiple
complications, the most significant being iatrogenic injury to the fornix. In our study we aim to establish the fact that use of Image
guidance while planning our trajectory can reduce the incidence of complications including forniceal injury as it significantly
alters the usual approach for ETV i.e. the coronal burr hole.
Materials and Methods:
This is a prospective observational study conducted in Liaquat National Hospital. A total of 43 patients
were included in the study which underwent ETV for hydrocephalus. Patients with history of head trauma age more than 70 and
with ETV being conducted without Image guidance were excluded from the study. Complications secondary to ETV were divided
into three major groups including Arterial Hemorrhage, Venous hemorrhage and injury to neural structures including fornix and
occulomotor nerve. Fornix contusions are graded structurally and data was compared with studies showing complications of ETV
without usage of Image guidance.
Results:
Among the 43 patients who underwent ETV with image guidance, only two patients (4.65%) had iatrogenic fornix
contusions. Neither of them developed memory impairment. None of the patients (0%) encountered other major iatrogenic
complications including injury to the mammilary bodies, basilar artery or occulomotor nerve.
Conclusion:
Use of Image guidance can reduce the trajectory related complications including hemorrhage and iatrogenic injury
to the fornix. In our study we observed that the altered trajectory was beneficial in avoiding major neurological structures while
introducing endoscope through the cortex into the ventricular system.
dr.sameerirfan@gmail.com