2001, Number 3
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ABSTRACTIntroduction: Brain endoscopy at present is used predominantly in certain cases of hydrocephalus, shunt dysfunction, and other neurosurgical diseases, especially when image studies fail to clearly reveal the aetiology. The purpose of this study was to compare endoscopic and preoperative tomographic images, and to determine the role of endoscopic under different pathological conditions. Method: From 1994 to 2000, we performed 22 endoscopies in 20 patients with different neurosurgical diseases such as hypertensive hydrocephalus, cerebrospinal fluid shunt dysfunction (CSFSD), intracranial cysts and hematomas, and cerebrospinal fluid (CSF) fistulas, as well as observing anatomical references during different open neurosurgical procedures. Results: We observed a direct correlation between endoscopic and tomographic images in nine procedures (40.91%). In five endoscopic procedures, the results were not demonstrated tomographically (22.73%), and in eight endoscopies (36.36%) the observations were completely different from CT scan images. In one case, endoscopy was very useful to observe the extension of the callosotomy as treatment for epilepsy, and in another two cases, to identify intraventricular structures in the transcallosal approach for third ventricle tumour resection. In a case of CSF fistula, exploration was successful with the use of the endoscopy. The present study demonstrated that endoscopic observation of the brain in cases of hydrocephalus, shunt dysfunction, and other diseases is very useful not only to confirm but also to rule out probable lesions diagnosed in the preoperative period. Endoscopy also demonstrated to be a valuable tool in operative field exploration during open neurosurgical procedures.
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