Review Article
Periventricular and Intraventricular Tumors in a Low-Income Country: Hard Learning Curve and Outcome of a Young Neurosurgeon from Burkina Faso
Ibrahim Dao*
,
Aminata Kièmtoré,
Ousmane Ouattara,
Frédéric Bako,
Jacques Traoré,
Joseph Biogo,
Serge Pacôme Yameogo,
Abdoulaye Sanou,
Eustache Kienou,
Louis Junior Comboigo,
Arsène Tossou,
Abdoulaye Thiombiano,
Lassané Taoko,
Henry Lankoandé,
Elie Nassoum,
Narcisse Ouédraogo,
Sosthène Fawaz Adéniran,
Astride Somda,
Delwendé Sylvain Zabsonré,
Abel Kabré
Issue:
Volume 8, Issue 1, June 2024
Pages:
1-10
Received:
10 March 2024
Accepted:
26 March 2024
Published:
17 April 2024
Abstract: Background: Periventricular and Intraventricular processes are life-threatening conditions because of their propensity to obstruct Cerebrospinal fluid pathways and to compress highly functional and vital structures. There are deep-seated lesions requiring rigorous microsurgical technic for their resection. Methods: We retrospectively analyzed the profile and outcome of Periventricular and intraventricular processes operated by the same author since his return in his country in 2015, after graduated abroad in WFNS Rabat training center program 2023. Result: We defined 15 patients operated over 8 years. There were 4 processes in lateral ventricle (26.6%), 1 in third ventricle (6.6%), 2 thalamus processes (13.3%), 4 in fourth ventricle (26.6%) and finally 4 in cerebellar hemisphere and violating the fourth ventricle (26.6%). Various surgical approaches were used, such as contralateral interhemispheric transcallosal, classical interhemispheric transcallosal, Subfrontal transbasal translamina terminalis, Frontal Transcortical, Temporal trans T2, ventriculoperitoneal shunting, endoscopy, cerebellar transcotical approach and Telovelar approach. Surgical procedure duration was more than 10 hours in 12 cases (80%) and one third of the patients have been operated in 2018. When neurosurgical operative microscope was not available, ophthalmologic microscope or binocular with headlight were used to achieve the resection. Pathological examination revealed High-grade glioma, subependymal giant cell astrocytoma (SEGA), central neurocytoma, Subependymoma, Hemangioblastoma, pilocytique astrocytoma, Medulloblastoma, gemiocytic astrocytoma, atypical papilloma of choroid plexus, craniopharygioma and cyst of septum pellucidum. We reported good postoperative outcome in 10 cases (66.6%), moderate postoperative deficit in 1 case and 4 cases of postoperative death (26.6%) among which 3 cases of postoperative meningitis. Conclusion: Periventricular and intraventricular processes can be safely approach in low-income country with acceptable result. However young African Neurosurgeon should be trained to be comfortable with multiple surgical approaches and also with binocular as well as with microscope. WFNS training program is a strong basement for the take-off of young African neurosurgeon. Backing home should be the rule after training, to develop neurosurgery.
Abstract: Background: Periventricular and Intraventricular processes are life-threatening conditions because of their propensity to obstruct Cerebrospinal fluid pathways and to compress highly functional and vital structures. There are deep-seated lesions requiring rigorous microsurgical technic for their resection. Methods: We retrospectively analyzed the p...
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Review Article
Cerebral Revascularization: Boom or Doom for Neurosurgeons
Avatar Singh*
Issue:
Volume 8, Issue 1, June 2024
Pages:
11-15
Received:
31 March 2024
Accepted:
29 April 2024
Published:
17 May 2024
DOI:
10.11648/j.ijn.20240801.12
Downloads:
Views:
Abstract: Cerebral revascularization which was once commonly used technique became outdated and emerged in a new avatar. Fisher was the first person who promoted that most strokes were not due to vasospasm but due to CA disease. Improvement of various microsurgical methods and techniques are resulting in excellent outcomes. With the advent of modern techniques, cerebral revascularization has taken a back seat. However many diseases like moyamoya disease, complex intracranial aneurysms and skull based tumours, traditional cerebral revascularization methods play a very important role. Although an important method to treat strokes but is also associated with dreaded complication of intracranial haemorrhage. Cerebral collateral circulation channels are restored by cerebral revascularization. Although very commonly used treatment but underwent various modifications, implementations, expanding the horizons of diseases involved. All these innovations in the use of endovascular technique resulted in the decline of cerebral revascularization surgeries. New endovascular surgical approaches lead to shorter recovery times and the patients whose conditions are not indicated for the traditional cerebrovascular approaches can also be managed. One of the major and important drawback of Cerebral Revascularization is the intraoperative thrombosis which can result in severe motor and sensory disturbances. This article aims to weigh the pros and cons of cerebral revascularization.
Abstract: Cerebral revascularization which was once commonly used technique became outdated and emerged in a new avatar. Fisher was the first person who promoted that most strokes were not due to vasospasm but due to CA disease. Improvement of various microsurgical methods and techniques are resulting in excellent outcomes. With the advent of modern techniqu...
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