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Fenestration of the superior medullary velum as treatment for a trapped fourth ventricle: A feasibility study
Author(s) -
Tubbs R. Shane,
Wellons John C.,
Salter George,
Oakes W. Jerry
Publication year - 2004
Publication title -
clinical anatomy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.667
H-Index - 71
eISSN - 1098-2353
pISSN - 0897-3806
DOI - 10.1002/ca.10185
Subject(s) - medicine , medullary cavity , fenestration , cadaveric spasm , shunting , anatomy , ventricle , fourth ventricle , surgery , cardiology
We developed a novel approach for fenestration of the trapped fourth ventricle utilizing the superior medullary velum (valve of Vieussens). Trapped fourth ventricles, which are seen often in the pediatric hydrocephalic population, are troublesome entities surgically. A right burr hole was carried out in 10 adult cadavers with no gross intracranial pathology and the superior medullary velum was fenestrated to the quadrigeminal cistern with the aid of an endoscope. This technique was carried out easily in all cadaveric specimens. With endoscopy, no vascular insult was appreciated either before or after fenestration of the superior medullary velum. These preliminary findings demonstrate that fenestration of the superior medullary velum may provide a good alternative to the present therapy of shunting trapped fourth ventricles, a therapy wrought with complications. Clin. Anat. 17:82–87, 2004. © 2004 Wiley‐Liss, Inc.