Avaliação da abordagem neuroendoscópica no tratamento da hidrocefalia monoventricular
Ano de defesa: | 2017 |
---|---|
Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | , , |
Tipo de documento: | Dissertação |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Universidade do Estado do Rio de Janeiro
|
Programa de Pós-Graduação: |
Programa de Pós-Graduação em Ciências Médicas
|
Departamento: |
Centro Biomédico::Faculdade de Ciências Médicas
|
País: |
BR
|
Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Área do conhecimento CNPq: | |
Link de acesso: | http://www.bdtd.uerj.br/handle/1/8826 |
Resumo: | Isolated expasion of one lateral ventricle, when unrelated to the ex-vacuum phenomenon due to hemispheric atrophy, is caused by unilateral obstruction of the foramen of Monro (FM). Increased pressure, caused by unilateral accumulation of the cerebrospinal fluid, causes deviation of the cerebral structures and progressively increases intracranial pressure. This condition is referred, in medical literature, as monoventricular hydrocephalus (MH) or unilateral hydrocephalus and surgical treatment is imperative. For the last 20 years, endoscopy has been the treatment of choice for this condition. Terminology application of this type of hydrocephalus is not uniform in the literature and the best endoscopic technique still remains undefined, mainly by limited number of published cases. To discuss the terminology used in the literature for hydrocephalus restricted to one lateral ventricle, to determine the endoscopic techniques used to treat the cases studied comparing the results with those presented in the literature and to present an endoscopic treatment flowchart of MH based on data obtained with this case series.Material and Method: in order to evaluate the best term for unilateral hydrocephalus due to FM obstruction, 19 English-language terms were searched in the PubMed database (http://www.ncbi.nlm.nih.gov/ pubmed). For this case series, a retrospective study of patients with hydrocephalus operated on by neuroendoscopy at the Pedro Ernesto University Hospital from 1995 to 2014 was carried out. Patients with a diagnosis of MH were selected. MH cases secondary to tumors were excluded. Results: 194 articles were obtained. All terms that did not describe lateral ventricle hydrocephalus or that described the cardiac ventricle were excluded. Of the 19 terms, only 7 continued for discussion. In the case review, 8 patients with different causes of MH were found: FM atresia, neurocysticercosis, arachnoid cyst, membrane obstruction of theFM and FM stenosis. The procedures performed were septostomy, foraminoplasty, membrane and cyst opening, lesions removal, choroid plexus coagulation and choroidal fissure opening. In all cases the endoscope was inserted into the hydrocephalic ventricle by precoronal frontal craniostomy. All patients had their MH completely solved by the endoscopic procedures. This terminological review suggests that hydrocephalus confined to one lateral ventricle without other sites of obstruction is best described by the terms unilateral hydrocephalus or HM, the first being the most popular. However, the use of terms inappropriately is not uncommon in the literature and may distort results interpretation. The endoscopic techniques used in our cases, with the exception of choroidal fissure opening, were described in the literature, also with a high success rate. The entry through the dilated lateral ventricle is not a consensus in the literature but it allows to perform all the endoscopic procedures necessary to restore cerebrospinal fluid flow and allows direct inspection of FM for etiological clarification. The endoscopic techniques employed varied according to the etiology of MH and can be used together without increasing morbidity. These techniques were arranged in anflowchart created based on this case series. |
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Nigri, Fláviohttp://lattes.cnpq.br/6109623959256650Dáquer, Egas Caparelli Moniz de Aragãohttp://lattes.cnpq.br/0851436431432190Simões, Elington Lanneshttp://lattes.cnpq.br/2856603304995871Madeira, Eugenio Pacelle Queirozhttp://lattes.cnpq.br/3658829863805551http://lattes.cnpq.br/3219201471130310Gobbi, Gabriel Neffa2021-01-05T19:43:28Z2018-07-312017-12-15GOBBI, Gabriel Neffa. Avaliação da abordagem neuroendoscópica no tratamento da hidrocefalia monoventricular. 2017. 78 f. Dissertação (Mestrado em Ciências Médicas) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2017.http://www.bdtd.uerj.br/handle/1/8826Isolated expasion of one lateral ventricle, when unrelated to the ex-vacuum phenomenon due to hemispheric atrophy, is caused by unilateral obstruction of the foramen of Monro (FM). Increased pressure, caused by unilateral accumulation of the cerebrospinal fluid, causes deviation of the cerebral structures and progressively increases intracranial pressure. This condition is referred, in medical literature, as monoventricular hydrocephalus (MH) or unilateral hydrocephalus and surgical treatment is imperative. For the last 20 years, endoscopy has been the treatment of choice for this condition. Terminology application of this type of hydrocephalus is not uniform in the literature and the best endoscopic technique still remains undefined, mainly by limited number of published cases. To discuss the terminology used in the literature for hydrocephalus restricted to one lateral ventricle, to determine the endoscopic techniques used to treat the cases studied comparing the results with those presented in the literature and to present an endoscopic treatment flowchart of MH based on data obtained with this case series.Material and Method: in order to evaluate the best term for unilateral hydrocephalus due to FM obstruction, 19 English-language terms were searched in the PubMed database (http://www.ncbi.nlm.nih.gov/ pubmed). For this case series, a retrospective study of patients with hydrocephalus operated on by neuroendoscopy at the Pedro Ernesto University Hospital from 1995 to 2014 was carried out. Patients with a diagnosis of MH were selected. MH cases secondary to tumors were excluded. Results: 194 articles were obtained. All terms that did not describe lateral ventricle hydrocephalus or that described the cardiac ventricle were excluded. Of the 19 terms, only 7 continued for discussion. In the case review, 8 patients with different causes of MH were found: FM atresia, neurocysticercosis, arachnoid cyst, membrane obstruction of theFM and FM stenosis. The procedures performed were septostomy, foraminoplasty, membrane and cyst opening, lesions removal, choroid plexus coagulation and choroidal fissure opening. In all cases the endoscope was inserted into the hydrocephalic ventricle by precoronal frontal craniostomy. All patients had their MH completely solved by the endoscopic procedures. This terminological review suggests that hydrocephalus confined to one lateral ventricle without other sites of obstruction is best described by the terms unilateral hydrocephalus or HM, the first being the most popular. However, the use of terms inappropriately is not uncommon in the literature and may distort results interpretation. The endoscopic techniques used in our cases, with the exception of choroidal fissure opening, were described in the literature, also with a high success rate. The entry through the dilated lateral ventricle is not a consensus in the literature but it allows to perform all the endoscopic procedures necessary to restore cerebrospinal fluid flow and allows direct inspection of FM for etiological clarification. The endoscopic techniques employed varied according to the etiology of MH and can be used together without increasing morbidity. These techniques were arranged in anflowchart created based on this case series.A dilatação isolada de um dos ventrículos laterais, quando não relacionada ao fenômeno ex-vácuo decorrente de atrofia hemisférica é causada por obstrução unilateral do foramen de Monro (FM). O aumento de pressão, causado pelo acúmulo unilateral do líquor, provoca o desvio das estruturas cerebrais e o aumento progressivo da pressão intracraniana. Esta condição é denominada na literatura como hidrocefalia monoventricular (HM) ou hidrocefalia unilateral e é imperativo o tratamento cirúrgico. Nos últimos 20 anos, a endoscopia é o tratamento de escolha para esta condição. A aplicação terminológica deste tipo de hidrocefalia não é uniforme na literatura e a melhor técnica endoscópica ainda permanece indefinida principalmente pelo número limitado de casos publicados. Discutir as terminologias utilizadas na literatura para as hidrocefalias restritas a um ventrículo lateral, determinar as técnicas endoscópicas utilizadas para o tratamento dos casos estudados comparando os resultados com os apresentadas na literatura e apresentar um fluxograma de tratamento endoscópico da HM com base nos dados obtidos nessa série de casos. Com o objetivo de avaliar o melhor termo para a dilatação unilateral ventricular pela obstrução do FM, foram pesquisados 19 termos da língua inglesa no banco de dados da PubMed (http://www.ncbi.nlm.nih.gov/pubmed). Para o estudo de casos, foi realizado um estudo retrospectivo dos pacientes com hidrocefalia operados no HUPE no período de 1995-2014 pelo método endoscópico. Foram selecionados pacientes com diagnóstico de HM e excluídos casos secundários a tumores. Na revisão terminológica, a partir de 194 artigos obtidos, foram excluídos todos os termos que não descreviam a hidrocefalia do ventrículo lateral ou que descreviam o ventrículo cardíaco. Dos 19 termos apenas 7 prosseguiram para discussão. Na revisão dos casos,foram encontrados 8 pacientes com diferentes causas de HM: atresia do FM, neurocisticercose, cisto aracnóide, obstrução do FM por membrana e estenose do FM. Os procedimentos realizados foram: septostomia, foraminoplastia, abertura de membranas, retirada de lesões, coagulação do plexo coróide e abertura da fissura coroidéia. Em todos os casos o endoscópio foi inserido por craniostomia pré-coronal, no lado do ventrículo hidrocefálico. Todos os paciente ficaram sem hidrocefalia e sem derivação ventricular. Esta revisão terminológica sugere que a hidrocefalia confinada a um ventrículo lateral, sem outros sítios de obstrução é melhor descrita pelos termos hidrocefalia unilateral ou HM, sendo a primeira a mais popular. Entretando, o uso inadequado dos termos não é raro na literatura e pode distorcer a avaliação dos resultados. As técnicas endoscópicas empregadas em nossos casos, com excessão da abertura da fissura coroidéia, foram descritas na literatura, também com alta taxa de sucesso. A entrada pelo ventrículo lateral dilatado não é um consenso na literatura, mas possibilita realizar todos os procedimentos endoscópicos necessários para restauração do fluxo liquórico e permite a inspeção direta do FM, fundamental para esclarecimento etiológico.As técnicas endoscópicas empregadas variaram de acordo com a etiologia da HM e podem ser empregadas em conjunto sem aumento da morbidade. Estas técnicas foram dispostas em um fluxograma criado apartir da série de casos.Submitted by Boris Flegr (boris@uerj.br) on 2021-01-05T19:43:28Z No. of bitstreams: 1 Gabriel Neffa Gobbi Dissertacao completa.pdf: 1930391 bytes, checksum: 11005c381c69d07b71076e05578154b5 (MD5)Made available in DSpace on 2021-01-05T19:43:28Z (GMT). No. of bitstreams: 1 Gabriel Neffa Gobbi Dissertacao completa.pdf: 1930391 bytes, checksum: 11005c381c69d07b71076e05578154b5 (MD5) Previous issue date: 2017-12-15application/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em Ciências MédicasUERJBRCentro Biomédico::Faculdade de Ciências MédicasNeuroendoscopyMonoventricular hydrocephalusUralateral hydrocephalusIsolated lateral ventricleSeptostomyNeuroendoscopiaHidrocefalia monoventricularHidrocefalia unilateralVentrículo lateral isoladoSeptostomiaHidrocefaliaHidrocefalia TratamentoCirurgia endoscópicaCirurgia endoscópicaVentrículos lateraisPressão intracranianaNeuroendoscopiaCNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::NEUROLOGIAAvaliação da abordagem neuroendoscópica no tratamento da hidrocefalia monoventricularAvaliação da abordagem neuroendoscópica no tratamento da hidrocefalia monoventricularEvaluation of the neuroendoscopic approach in the treatment of monoventricular hydrocephalusEvaluation of the neuroendoscopic approach in the treatment of monoventricular hydrocephalusinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALGabriel Neffa Gobbi Dissertacao completa.pdfapplication/pdf1930391http://www.bdtd.uerj.br/bitstream/1/8826/1/Gabriel+Neffa+Gobbi+Dissertacao+completa.pdf11005c381c69d07b71076e05578154b5MD511/88262024-02-26 16:00:10.215oai:www.bdtd.uerj.br:1/8826Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032024-02-26T19:00:10Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false |
dc.title.por.fl_str_mv |
Avaliação da abordagem neuroendoscópica no tratamento da hidrocefalia monoventricular Avaliação da abordagem neuroendoscópica no tratamento da hidrocefalia monoventricular |
dc.title.alternative.eng.fl_str_mv |
Evaluation of the neuroendoscopic approach in the treatment of monoventricular hydrocephalus Evaluation of the neuroendoscopic approach in the treatment of monoventricular hydrocephalus |
title |
Avaliação da abordagem neuroendoscópica no tratamento da hidrocefalia monoventricular |
spellingShingle |
Avaliação da abordagem neuroendoscópica no tratamento da hidrocefalia monoventricular Gobbi, Gabriel Neffa Neuroendoscopy Monoventricular hydrocephalus Uralateral hydrocephalus Isolated lateral ventricle Septostomy Neuroendoscopia Hidrocefalia monoventricular Hidrocefalia unilateral Ventrículo lateral isolado Septostomia Hidrocefalia Hidrocefalia Tratamento Cirurgia endoscópica Cirurgia endoscópica Ventrículos laterais Pressão intracraniana Neuroendoscopia CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::NEUROLOGIA |
title_short |
Avaliação da abordagem neuroendoscópica no tratamento da hidrocefalia monoventricular |
title_full |
Avaliação da abordagem neuroendoscópica no tratamento da hidrocefalia monoventricular |
title_fullStr |
Avaliação da abordagem neuroendoscópica no tratamento da hidrocefalia monoventricular |
title_full_unstemmed |
Avaliação da abordagem neuroendoscópica no tratamento da hidrocefalia monoventricular |
title_sort |
Avaliação da abordagem neuroendoscópica no tratamento da hidrocefalia monoventricular |
author |
Gobbi, Gabriel Neffa |
author_facet |
Gobbi, Gabriel Neffa |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Nigri, Flávio |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/6109623959256650 |
dc.contributor.referee1.fl_str_mv |
Dáquer, Egas Caparelli Moniz de Aragão |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/0851436431432190 |
dc.contributor.referee2.fl_str_mv |
Simões, Elington Lannes |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/2856603304995871 |
dc.contributor.referee3.fl_str_mv |
Madeira, Eugenio Pacelle Queiroz |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/3658829863805551 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/3219201471130310 |
dc.contributor.author.fl_str_mv |
Gobbi, Gabriel Neffa |
contributor_str_mv |
Nigri, Flávio Dáquer, Egas Caparelli Moniz de Aragão Simões, Elington Lannes Madeira, Eugenio Pacelle Queiroz |
dc.subject.eng.fl_str_mv |
Neuroendoscopy Monoventricular hydrocephalus Uralateral hydrocephalus Isolated lateral ventricle Septostomy |
topic |
Neuroendoscopy Monoventricular hydrocephalus Uralateral hydrocephalus Isolated lateral ventricle Septostomy Neuroendoscopia Hidrocefalia monoventricular Hidrocefalia unilateral Ventrículo lateral isolado Septostomia Hidrocefalia Hidrocefalia Tratamento Cirurgia endoscópica Cirurgia endoscópica Ventrículos laterais Pressão intracraniana Neuroendoscopia CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::NEUROLOGIA |
dc.subject.por.fl_str_mv |
Neuroendoscopia Hidrocefalia monoventricular Hidrocefalia unilateral Ventrículo lateral isolado Septostomia Hidrocefalia Hidrocefalia Tratamento Cirurgia endoscópica Cirurgia endoscópica Ventrículos laterais Pressão intracraniana Neuroendoscopia |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::NEUROLOGIA |
description |
Isolated expasion of one lateral ventricle, when unrelated to the ex-vacuum phenomenon due to hemispheric atrophy, is caused by unilateral obstruction of the foramen of Monro (FM). Increased pressure, caused by unilateral accumulation of the cerebrospinal fluid, causes deviation of the cerebral structures and progressively increases intracranial pressure. This condition is referred, in medical literature, as monoventricular hydrocephalus (MH) or unilateral hydrocephalus and surgical treatment is imperative. For the last 20 years, endoscopy has been the treatment of choice for this condition. Terminology application of this type of hydrocephalus is not uniform in the literature and the best endoscopic technique still remains undefined, mainly by limited number of published cases. To discuss the terminology used in the literature for hydrocephalus restricted to one lateral ventricle, to determine the endoscopic techniques used to treat the cases studied comparing the results with those presented in the literature and to present an endoscopic treatment flowchart of MH based on data obtained with this case series.Material and Method: in order to evaluate the best term for unilateral hydrocephalus due to FM obstruction, 19 English-language terms were searched in the PubMed database (http://www.ncbi.nlm.nih.gov/ pubmed). For this case series, a retrospective study of patients with hydrocephalus operated on by neuroendoscopy at the Pedro Ernesto University Hospital from 1995 to 2014 was carried out. Patients with a diagnosis of MH were selected. MH cases secondary to tumors were excluded. Results: 194 articles were obtained. All terms that did not describe lateral ventricle hydrocephalus or that described the cardiac ventricle were excluded. Of the 19 terms, only 7 continued for discussion. In the case review, 8 patients with different causes of MH were found: FM atresia, neurocysticercosis, arachnoid cyst, membrane obstruction of theFM and FM stenosis. The procedures performed were septostomy, foraminoplasty, membrane and cyst opening, lesions removal, choroid plexus coagulation and choroidal fissure opening. In all cases the endoscope was inserted into the hydrocephalic ventricle by precoronal frontal craniostomy. All patients had their MH completely solved by the endoscopic procedures. This terminological review suggests that hydrocephalus confined to one lateral ventricle without other sites of obstruction is best described by the terms unilateral hydrocephalus or HM, the first being the most popular. However, the use of terms inappropriately is not uncommon in the literature and may distort results interpretation. The endoscopic techniques used in our cases, with the exception of choroidal fissure opening, were described in the literature, also with a high success rate. The entry through the dilated lateral ventricle is not a consensus in the literature but it allows to perform all the endoscopic procedures necessary to restore cerebrospinal fluid flow and allows direct inspection of FM for etiological clarification. The endoscopic techniques employed varied according to the etiology of MH and can be used together without increasing morbidity. These techniques were arranged in anflowchart created based on this case series. |
publishDate |
2017 |
dc.date.issued.fl_str_mv |
2017-12-15 |
dc.date.available.fl_str_mv |
2018-07-31 |
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2021-01-05T19:43:28Z |
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GOBBI, Gabriel Neffa. Avaliação da abordagem neuroendoscópica no tratamento da hidrocefalia monoventricular. 2017. 78 f. Dissertação (Mestrado em Ciências Médicas) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2017. |
dc.identifier.uri.fl_str_mv |
http://www.bdtd.uerj.br/handle/1/8826 |
identifier_str_mv |
GOBBI, Gabriel Neffa. Avaliação da abordagem neuroendoscópica no tratamento da hidrocefalia monoventricular. 2017. 78 f. Dissertação (Mestrado em Ciências Médicas) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2017. |
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Universidade do Estado do Rio de Janeiro |
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