[Indications for neuroendoscopy].

Abstract

INTRODUCTION: In order to reduce intracerebral trauma in the diagnosis and treatment of intracranial lesions in children, neuroendoscopy is an important tool in current neurosurgery. Using this minimally invasive technique intraventricular objectives may be approached with little damage caused to adjacent structures. OBJECTIVES: There are two aspects to current indications for neuroendoscopy. Firstly, diagnosis is achieved by taking intraventricular biopsies of cystic lesions and tumours and for anatominical vigilance in microsurgical operations. Secondly, there is the therapeutic aspect, especially in operations to restore the circulation of cerebrospinal fluid (CSF), correct complex hydrocephaly, insert or remove intraventricular shunts, aspiration of cysts or haematomas, fenestration of cysts, resection of tumours within or near the ventricles. DEVELOPMENT: At the present time in neurosurgical paediatric management, neuroendoscopy is a tool used daily in common lesions such as hydrocephaly and the identification of intraventricular lesions. It may be safely used as a primary method of approach to the lesions or as a complement to open or guided surgery to the patient s advantage. We therefore reviewed the literature in the light of our own experience in neuroendoscopy since 1996. CONCLUSIONS: The formal indications for neuroendoscopy are greater in paediatric neurosurgery. In fact, the management of the CSF circulation, and disorders associated with this, together with the identification of tumours using minimally invasive methods, make this technique directly useful for solving these problems. This is most obvious in lesions such as multiseptate complex hydrocephaly, and intraventricular tumours and cysts where it is the first surgical option. In the short term, thanks to improvements in neuro navigation and frameless stereotaxis, its use will be wider and more precise