caa a22 4500 463179285 CHVBK 20180406164834.0 cr unu---uuuuu 170326e20070601xx s 000 0 eng 10.1007/s00381-007-0333-6 doi (NATIONALLICENCE)springer-10.1007/s00381-007-0333-6 Complications following endoscopic intracranial procedures in children [Elektronische Daten] [Giuseppe Cinalli, Pietro Spennato, Claudio Ruggiero, Ferdinando Aliberti, Vincenzo Trischitta, Maria Consiglio Buonocore, Emilio Cianciulli, Giuseppe Maggi] Background: The significant technological improvement of endoscopic instrumentation has allowed, in the last 10years, a widespread diffusion of neuroendoscopic procedures. Nevertheless, severe, sometimes life-threatening, complications may occur during neuroendoscopic surgery, and the incidence and age specificity of complications in children have been underdescribed so far. Materials and methods: Complications recorded in a prospectively collected database of pediatric patients undergoing neuroendoscopic procedures were analysed; the medical histories of the patients and the surgical procedures were reviewed. Results: Complications occurred in 32 out of 231 (13.8%) procedures performed for the management of obstructive hydrocephalus (137), multiloculated hydrocephalus (53), arachnoid cysts (29) and intraventricular tumors (12). Subdural hygroma occurred in 11 cases, seven requiring subdural shunting. In one of these cases, infection of the subdural space occurred and required a craniotomy. Cerebrospinal fluid (CSF) infection occurred in 11 cases. In one case, a frontal abscess developed and was managed with craniotomy. CSF leak occurred in nine cases, intraventricular haemorrhages in two, technical failures in seven, subcutaneous CSF collection (managed with lumbo-peritoneal shunt) in one, thalamic contusion and post-operative transient akinetic mutism in one. This patient suddenly died 6months later, probably as a consequence of closure of the stoma. Two patients developed secondary compartmentalisation of the ventricles after complicated endoscopic third ventriculostomy. In nine cases, these complications were associated. Overall, no patient died after the procedure (operative mortality 0), one patient died 6months after the procedure for unexplained events (sudden death rate 0.4%), and three patients presented permanent disability as a consequence of surgical complication (permanent morbidity 1.3%). Conclusions: Complication rate of neuro-endoscopic procedures is not negligible even in experienced hands. The majority are minor complications which do not affect the final outcome, but sporadically major events may occur, leading to significant problems in surgical management and, occasionally, to permanent disabilities. Careful selection of patients on pre-operative imaging studies and intensive training of surgeons are mandatory to improve results. Springer-Verlag, 2007 Neuroendoscopy nationallicence Endoscopic third ventriculostomy nationallicence Hydrocephalus nationallicence Complications nationallicence Children nationallicence Cinalli Giuseppe Department of Pediatric Neurosurgery, Santobono Children's Hospital, Naples, Italy aut Spennato Pietro Department of Pediatric Neurosurgery, Santobono Children's Hospital, Naples, Italy aut Ruggiero Claudio Department of Pediatric Neurosurgery, Santobono Children's Hospital, Naples, Italy aut Aliberti Ferdinando Department of Pediatric Neurosurgery, Santobono Children's Hospital, Naples, Italy aut Trischitta Vincenzo Department of Pediatric Neurosurgery, Santobono Children's Hospital, Naples, Italy aut Buonocore Maria Consiglio Department of Pediatric Neuroradiology, Santobono Children's Hospital, Naples, Italy aut Cianciulli Emilio Department of Pediatric Neuroradiology, Santobono Children's Hospital, Naples, Italy aut Maggi Giuseppe Department of Pediatric Neurosurgery, Santobono Children's Hospital, Naples, Italy aut Child's Nervous System Springer-Verlag 23/6(2007-06-01), 633-644 0256-7040 23:6<633 2007 23 381 https://doi.org/10.1007/s00381-007-0333-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00381-007-0333-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Cinalli Giuseppe Department of Pediatric Neurosurgery, Santobono Children's Hospital, Naples, Italy aut NATIONALLICENCE 700 1- Spennato Pietro Department of Pediatric Neurosurgery, Santobono Children's Hospital, Naples, Italy aut NATIONALLICENCE 700 1- Ruggiero Claudio Department of Pediatric Neurosurgery, Santobono Children's Hospital, Naples, Italy aut NATIONALLICENCE 700 1- Aliberti Ferdinando Department of Pediatric Neurosurgery, Santobono Children's Hospital, Naples, Italy aut NATIONALLICENCE 700 1- Trischitta Vincenzo Department of Pediatric Neurosurgery, Santobono Children's Hospital, Naples, Italy aut NATIONALLICENCE 700 1- Buonocore Maria Consiglio Department of Pediatric Neuroradiology, Santobono Children's Hospital, Naples, Italy aut NATIONALLICENCE 700 1- Cianciulli Emilio Department of Pediatric Neuroradiology, Santobono Children's Hospital, Naples, Italy aut NATIONALLICENCE 700 1- Maggi Giuseppe Department of Pediatric Neurosurgery, Santobono Children's Hospital, Naples, Italy aut NATIONALLICENCE 773 0- Child's Nervous System Springer-Verlag 23/6(2007-06-01), 633-644 0256-7040 23:6<633 2007 23 381 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer