Neuro-Endoscopy for Head and Spinal Trauma

Neurotrauma

Head and Spinal Trauma

Neurotrauma is a critical public health problem that deserves the attention of the world's health community. Estimates of brain and spinal cord injury occurrence indicate that these injuries cause enormous losses to individuals, families, and communities. They result in a large number of deaths and impairments leading to permanent disabilities. Research has also shown that traumatic brain injury (TBI) usually requires long-term care and therefore incurs economic cost to health systems. For this reason, many countries need to develop surveillance systems and conduct epidemiologic studies to measure the impact of neurotrauma among their people to guide the development of more effective preventive methods. A number of methods have already proven effective, such as the use of motorcycle helmets, head supports in vehicles or on sports equipment.

Neuro-Endoscopy

Neuro-Endoscopy is a subbranch of endoscopy and a minimally invasive medical procedure in which the ailments of the brain are treated by endoscopes.
The most common surgical procedure being performed through Neuroendoscope is Endoscopic Third Ventriculostomy or, E3V for the treatment of Hydrocephalus.
Still there is probably a lot more to discover than has actually been done.

To Start With

The human brain covering called Cranium, or, Brain box.
Further in, brain covered with 3 layers from

Outwards to Inwards by –

Duramater
Arachnoid membrane
Piamater

Brain filled with a fluid called Cerebro Spinal fluid, CSF.

Endoscopic Surgery Applications

Ventricular Surgery	Tumor Surgery
Shunt / Stent Placement	Biopsy ventricular tumors.
Making alternative way for cysts/ Fenestration of cysts.	Resection/cutting open ventricular tumors.
Third Ventriculostomy	Evacuation of haematomas (blood clots) / cysts.
	Skull base surgery complications.

Primary Ailments

Ailments / Diseases treated with the help of Neuro -Endoscopy are as follows:

Hydrocephalus (Water in Brain)

Excess of fluid (CSF) or water due to overproduction in the brain existing generally in the different ventricles. Surgery is named as Third Ventriculostomy.

Resection/Cutting of Colloid cyst and Tumor Diagnosis

Collection of gelatinous material, generally found in the third ventricle of brain.

Treatment of Arachnoid cysts

These are CSF (Cerebro Spinal Fluid) filled sacs, which are inborn or, congenital lesions existing on the Arachnoid layer of the brain.

Tumor Biopsy and Haematomas

Haematomas are blood clot formations existing in any of the several layers of the brain. (Duramater, Piamater, Arachnoid)

Surgical Treatment of Hydrocephalus

Objective : To remove excess CSF thus decreasing the ICP and establish contact with the adjoining cavities.

A SHUNT - By draining the fluid
A VENTRICULOSTOMY - By re-opening the passages between cistern cavities.

How is it done ???

All the Neurosurgeries are done in General Anesthesia and so Ventriculostomy also.
Patient is placed at dorsal position with head bent at 30°.
The incision / Burr hole is created at the anterior of the skull and thus the entry to the skull is completed.
Some of the CSF flows out with force due to the presence of ICP , or , Intra Cranial Pressure.
Further entry to the brain is achieved by cutting open the membrane / floor of the third ventricle.
The size of the skull shrinks gradually due to the removal of excess CSF.