Neuroendoscopic Lavage for the Treatment of Posthemorrhagic Hydrocephalus in Neonates

  • Gesa Cohrs
  • Ulrich W. Thomale
  • Valentina Pennacchietti

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Intraventricular hemorrhage (IVH) is still one of the major complications of neonatal patient care. Neuroendoscopic lavage offers the opportunity to remove blood clots and their degradation products in order to re-establish CSF circulation and normalize intracranial pressure. All stages of neuroendoscopic lavage will be presented, including patient positioning, draping, skin incision, butthole position, use of irrigation, removal of blood clots, and the use of additional endoscopic techniques such as septostomy. The video also addresses the details of reservoir placement and wound closure. In this very fragile cohort of neonatal patients, intraoperative positioning and management are of particular interest and are explained in depth. The surrounding technical equipment and diagnostic tools, such as ultrasound and endoscopic instruments used, are explained.

Overview

This video will describe all stages of neuroendoscopic lavage, and will discuss the surrounding technical equipment and diagnostic tools.

About The Authors

Gesa Cohrs

Gesa Cohrs , MD, Neurosurgeon, Pediatric Neurosurgery, Charité Universitätsmedizin Berlin, Berlin, German

 
Ulrich W. Thomale

Ulrich W. Thomale , MD, Head of Pediatric Neurosurgery at the Head of Paediatric Neurosurgery at the Charité - University Medicine of Berlin. He is also Chairman of the Scientific Committee of the European Society of Pediatric Neurosurgery (ESPN), Member of the Executive Board of the European and International Society of Pediatric Neurosurgery (ESPN/ ISPN), Member of the Executive Board of the International Federation of Neuroendoscopy (IFNE) and Co-Chairman Section of Pediatric Neurosurgery of the German Society for Neurosurgery (DGNC)

 
Valentina Pennacchietti

Valentina Pennacchietti , MD, Neurosurgeon, Pediatric Neurosurgery, Charité Universitätsmedizin Berlin, Berlin, German

 

About this video

Author(s)
Gesa Cohrs
Ulrich W. Thomale
Valentina Pennacchietti
DOI
https://doi.org/10.1007/978-3-031-58139-7
Online ISBN
978-3-031-58139-7
Total duration
39 min
Publisher
Springer, Cham
Copyright information
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2024

Video Transcript

This video shows neuroendoscopic lavage for the treatment of posthemorrhagic hydrocephalus in neonates.

My name is Gesa Cohrs. and on behalf of the entire pediatric neurosurgical team at the Charité, I am presenting this case of a prematurely born girl at 29 plus 2 weeks of gestation, who suffered from intraventricular hemorrhage grade 3 with intraparenchymal hemorrhage on the left side. She was treated due to increased ventricular size and progressive signs of raised intracranial pressure with neuroendoscopic lavage at 31 weeks of gestation with a body weight of 1,300 grams.

We want to outline the details of the procedure demonstrating techniques for planning the approach, performing the lavage, the clot aspiration, and the septostomy guided by intraoperative ultrasound. Not only surgical details are shown, but also particularities of patient positioning, implanted materials, and wound closure. Further, we want to reflect on our treatment protocol in these cases considering the presented case.