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An optimized technique of endoscopic third ventriculocisternostomy (ETV) for children with occlusive hydrocephalus
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01.07.2018 |
Sufianov A.
Kasper E.
Sufianov R.
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Neurosurgical Review |
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1 |
Ссылка
© 2017, Springer-Verlag GmbH Germany, part of Springer Nature. In this article, we present an optimized minimally invasive technique of ETV for children with occlusive hydrocephalus. The study comprises of 64 consecutive pediatric cases (34 boys and 30 girls aged from 1 month to 5 years) of occlusive hydrocephalus from various etiologies, which were treated with a modified technique of ETV. Mean clinical follow-up period after ETV was 24.2 ± 3.8 months. Application of the new technique made it possible to significantly reduce the length of the soft tissue incision for access, and the use of upgraded instruments allowed to perform a twist drill hole in the skull to less than half a usual size. Access to the brain and lateral ventricle was performed by blunt trephination of the dura without the need for significant corticectomy or coagulation, and yielded minimal damage to the brain, which is very important in patients of young age. Continued endoscopic control during the approach down to the lateral ventricle increases safety and decreases risk of injury, and can be performed in cases of pathologies affecting the anatomical relationships of the lateral and third ventricle. Mortality in our cohort was 0%, and there were no postoperative neurological, endocrinological, or infectious complications. Patency rates of the first ETV performed was 78%, with the remaining patients requiring additional surgical procedures for complicated settings. This new technique of minimally invasive ETV placement in pediatric patients is an effective and safe method to treat occlusive hydrocephalus and can be recommended for extensive clinical use.
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The specific features of the blood stains depending on their volume
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01.01.2018 |
Nagornov M.
Leonova E.
Semenov A.
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Sudebno-Meditsinskaya Ekspertiza |
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0 |
Ссылка
© 2018 Media Sphera Publishing Group. All rights reserved. The objective of the present study was to determine the minimal and maximum volume of blood droplets freely falling from various droplet-forming surfaces and to characterize the specific morphological features of the resulting stains. The experiments were designed so that the blood droplets were allowed to fall down from the height of 10 cm to 1.5 m. The drop volume varied from 5 mcl to 134 mcl depending on the shape of the objects and the area of the droplet-forming surfaces. The size of the blood stains ranged from 0.4 to 2.4 cm. The stains of a smaller size were regarded as splashes while a stain resulting from the fall of a droplet having a volume greater than 200 mcl was considered to be a result of merging of several droplets and was termed «blood volume». The morphological features of the blood stains of different volume are described.
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