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PubMed1998

Effect of allogenic freeze-dried demineralized bone matrix on guided tissue regeneration in dogs.

This randomized, split-mouth study was designed to evaluate the adjunctive effect of allogenic, freeze-dried, demineralized bone matrix (DBM) to guided tissue regeneration (GTR). Contralateral fenestration defects (6 x 4 mm) were created 6 mm apical to the buccal alveolar crest on maxillary canine teeth in 6 beagle dogs. DBM was implanted into one randomly selected fenestration defect. Expanded polytetrafluoroethylene (ePTFE) membranes were used to provide bilateral GTR. Tissue blocks including defects with overlying membranes and soft tissues were harvested following a four-week healing interval and prepared for histometric analysis. Differences between GTR+DBM and GTR defects were evaluated using a paired t-test (N = 6). DBM was discernible in all GTR+DBM defects with limited, if any, evidence of bone metabolic activity. Rather, the DBM particles appeared solidified within a dense connective tissue matrix, often in close contact to the instrumented root. There were no statistically significant differences between the GTR+DBM versus the GTR condition for any histometric parameter examined. Fenestration defect height averaged 3.7+/-0.3 and 3.9+/-0.3 mm, total bone regeneration 0.8+/-0.6 and 1.5+/-0.8 mm, and total cementum regeneration 2.0+/-1.3 and 1.6+/-1.7 mm for GTR+DBM and GTR defects, respectively. The histologic and histometric observations, in concert, suggest that allogenic freeze-dried DBM has no adjunctive effect to GTR in periodontal fenestration defects over a four-week healing interval. The critical findings were 1) the DBM particles remained, embedded in dense connective tissue without evidence of bone metabolic activity; and 2) limited and similar amounts of bone and cementum regeneration were observed for both the GTR+DBM and GTR defects.

Alveolar Bone Loss↗
PubMed1992

Selective resection of the semicircular canals of rabbits with preservation of hearing.

The goal of this investigation was to develop a method of surgical removal of the semicircular canals of the rabbit without induction of auditory impairment. Four different surgical techniques were utilized: i) fenestration of the lateral semicircular canal; ii) fibrin glue perfusion of the canal following fenestration; iii) removal of the lateral semicircular canal by drilling after fenestration and fibrin glue perfusion, and iv) removal of all three canals after fenestration and fibrin gluing. Brainstem auditory potentials were recorded repeatedly for up to 3 months after operation and demonstrated preservation of hearing in all rabbits in the first group and in 78% of the second group. In the third group the potentials could be recorded in 67% of the animals and showed a 20 dB deterioration of hearing. After removal of all three semicircular canals residual hearing could be recorded in 50% of the rabbits. These animals regularly showed a 30-40 dB deterioration of hearing. A precise microsurgical technique using fibrin glue and bone chips for interruption of the peri- and endolymph flow proved crucial for hearing preservation.

Animals↗
PubMed1995

Endoscopic treatment of loculated hydrocephalus.

Loculated hydrocephalus remains a difficult neurosurgical problem and endoscopes designed to navigate through the ventricular system provide a new option for treatment. The authors review their experience, during the period March 1990 to June 1993, using a steerable fiberscope in 34 cases of loculated hydrocephalus to evaluate the efficacy of endoscopic cyst fenestration. The goals of treatment were to control hydrocephalus, simplify preexisting shunt systems, and reduce operative morbidity. Endoscopic cyst fenestrations reduced the shunt revision rate from 3.04 per year prior to endoscopy to 0.25 per year after the procedure, during a follow-up period ranging from 8 to 45 months, mean 26 months. However, eight patients (23.5%) required 14 repeat operations to control loculated hydrocephalus. After endoscopy, patients with multiloculated hydrocephalus had a nearly fivefold increased risk (relative risk 4.85) for shunt malfunction and more than a twofold increased risk (relative risk 2.43) for cyst recurrence versus patients with uniloculated hydrocephalus. Similarly, six (50%) of 12 patients shunted prior to endoscopy required a repeat endoscopic procedure (relative risk 5.56). Although repeat endoscopic procedures may be required to control hydrocephalus, endoscopic cyst fenestration avoided placement of a shunt in seven (33%) of 21 patients with uniloculated hydrocephalus. One patient, encountered early in the authors' experience, required a craniotomy for fenestration of multiple ventricular cysts. Endoscopic complications included cerebrospinal fluid leakage in one case and ventriculitis in another. The authors conclude that endoscopic treatment of loculated hydrocephalus is a safe, minimally invasive technique that should be considered as the initial treatment option.

Adolescent↗
PubMed2004

Hydrocephalus in children with middle fossa arachnoid cysts.

OBJECT: The optimal management of children with middle fossa arachnoid cysts (MFACs) remains controversial. In this study the authors evaluated the relationship between two preoperative variables, hydrocephalus and nonspecific macrocephaly, in children undergoing fenestration of temporal arachnoid cysts and hydrocephalus-related shunt placement. METHODS: During a 16-year period, 40 children (30 boys and 10 girls) underwent treatment of MFACs. All but one patient experienced either worsening symptoms or progressive serial imaging-documented cyst enlargement. Hydrocephalus was present in six patients and nonspecific macrocephaly in another nine. The mean age at surgery was 66 months (range 1-201 months, median 36 months), and the mean follow-up duration was 54 months (range 6-83 months, median 39 months). All patients presenting with hydrocephalus required placement of a ventriculoperitoneal (VP) shunt as well as cyst fenestration, regardless of which procedure was performed first. Five patients with macroencephaly undergoing initial fenestration required subsequent VP shunt insertion. Complications of cerebrospinal fluid (CSF) diversion were typical. CONCLUSIONS: Patients with hydrocephalus or macrocephaly are likely to require VP shunt placement in addition to cyst fenestration. Children with nonspecific macrocephaly may harbor a latent derangement of CSF circulation.

Adolescent↗
PubMedDate not supplied

Ambulatory 24-hour electrocardiographic monitoring following total cavopulmonary connection.

A total of 72 patients (53 males, 19 females) in the age range 1-22 years (mean 6.4 years) who underwent univentricular repair between April 1990 and May 1997 at our institute were followed up from six months to seven years (mean 3.6 years). Twenty-four hours ambulatory electrocardiographic Holter monitoring was done in all the patients. Thirty-four out of 40 patients (85%) who underwent fenestrated total cavopulmonary connection and 25 out of 32 patients (78%) who underwent non-fenestrated total cavopulmonary connection had normal Holter recording; thus 59 out of 72 (82%) patients had normal findings. Among the fenestrated total cavopulmonary connections, three patients each had atrial tachycardia and sinus bradycardia. In the non-fenestrated group, two patients had atrial tachycardia, three had supraventricular tachycardia, one sinus bradycardia and one had intermittent ventricular tachycardia. No correlation was found between age at surgery, pre-operative morphology, cross clamp time or cardiopulmonary bypass time with post-operative arrhythmia. To conclude, post-operative arrhythmias following total cavopulmonary connection were not related to age at surgery, pre-operative morphology, cross clamp or cardiopulmonary bypass time. However, a larger patient pool and longer follow-up is required for evaluation of any definitive correlation.

Adolescent↗
PubMed2003

[Vitreous changes in Stickler syndrome].

We report the ultrastructural feature of a vitreous membrane with multiple fenestrations in a case of a 40-year-old woman with a Stickler syndrome. The left eye showed a type 2 vitreous phenotype. Vitreous abnormalities of the right eye may correspond to phenotypic conversion to a type 1 appearance of a type 2 vitreous phenotype. Fenestrated membrane may correspond to posterior hyaloid membrane in complete posterior vitreous detachment in this phenotypic conversion. Fenestrated membrane consisted of avascular fibrocellular tissue with cells arranged in a cohesive pattern around the fenestration. Ultrastructural findings of cells were characteristic of proliferative Müller cells. Ultrastructural examination of collagen fibrils showed them to be similar to normal vitreous. This finding suggests that collagen molecules are not functionally altered and are probably quantitatively insufficient during vitreous development.

Abnormalities, Multiple↗
PubMed1992

Detrimental sequelae on the wall of the internal mammary artery caused by hydrostatic dilation with diluted papaverine solution.

We studied the effect of hydrostatic dilation of the internal mammary artery used for coronary revascularization in 10 patients (aged 45 to 79 years, median 63 years). Diluted papaverine solution was injected in the lumen of distal segments of the internal mammary artery, the musculophrenic artery, or the superior epigastric artery that had been obtained at operation; injection was followed by hydrostatic dilation not exceeding a sheer force of 50 gm. In 12 control patients (aged 42 to 76 years, median 64 years) in whom the internal mammary artery had also been harvested for elective myocardial revascularization, similar arterial segments were wrapped in sponges soaked in papaverine solution of the same dilution. In the nondilated group the median (with interquartile range) number of fenestrations in the internal elastic lamina increased from the elastic (21, 7) to the elastomuscular (41, 11) and muscular segments (89, 12) (elastic-elastomuscular: p = 0.006; elastic-muscular: p = 0.006; elastomuscular-muscular: p = 0.003) (Wilcoxon signed-rank test). In none of the three histologic segments were full-thickness disruptions of the intima and disruptions of the internal elastic lamina seen. Similarly, in the dilated group the number of fenestrations in the internal elastic lamina increased from the elastic (25, 18) to the elastomuscular (43, 9) and muscular (100, 13) segments (p values 0.01, 0.01, and 0.006, respectively). In addition, in 20% of the elastic sections, in 17% of the elastomuscular sections, and in 35% of the muscular sections of the dilated group, disruptions of the intima and internal elastic lamina were seen. Comparison of the number of fenestrations in internal elastic lamina in the three histologic segments between the nondilated and dilated groups revealed a significantly greater value in the muscular segments of the latter group (p = 0.01) (Mann-Whitney U test). We concluded that (1) hydrostatic dilation of the internal mammary, musculophrenic, and superior epigastric arteries may have detrimental effects on the histologic characteristics of the intima and the internal elastic lamina and (2) the number of fenestrations in the internal elastic lamina of these arteries is related to the presence or absence of elastic lamellae in the media.

Aged↗
PubMed1992

Luminal constrictions on corrosion casts of capillaries and postcapillary venules in rat exocrine pancreas correspond to pericyte processes.

The rat exocrine pancreas was studied as a model to demonstrate morphological features of different types of capillaries, using scanning electron microscopy of vascular corrosion casts and transmission electron microscopy of tissue sections. Two types of capillaries were discerned. The first type represents less undulated, slender, straight capillaries with numerous, shallow, circular or semilunar furrows on its cast's surface. In tissue sections, this type probably corresponds to non-fenestrated capillaries. The numerous grooves on its cast correspond to pericyte processes beneath the endothelial lining. The second type comprises capillaries of an undulated course and variable diameter with less numerous furrows. In addition, these casts showed circumscribed, smooth surfaced bulging areas defined by the grooves described. In tissue sections, this type probably corresponds to fenestrated capillaries, the bulging areas on its cast correspond to fenestrated regions of the endothelium. Fenestrated areas of capillary endothelium are less reinforced; pericyte processes are not present beneath these regions in tissue sections. The hypothesis that pericyte processes are responsible for surface indentations on capillary casts was supported by observations on postcapillary venules. Casts of these vascular segments showed also numerous circularly running furrows. Accordingly, the wall of postcapillary venules is provided with pericytes while smooth muscle cells are missing.

Animals↗
PubMed2003

Characterization and treatment of systemic venous to pulmonary venous collaterals seen after the Fontan operation.

OBJECTIVES: To determine the anatomical characteristics of systemic venous collaterals formed after the Fontan operation, and the efficacy of a transcatheter strategy for management. METHODS: We reviewed retrospectively the data from cardiac catherization of 50 persistently cyanotic patients after the Fontan operation. RESULTS: A total of 54 transcatheter interventions were performed, at a mean age of 6.3 +/- 3.5 years, a mean interval of 2.7 +/- 2.9 years from completion of the Fontan circulation. Of 38 patients who had fenestration of the baffle at the time of surgery, 25 had patency of the fenestration, and 24 had the fenestration occluded with a device at the time of interventional treatment for associated venous collaterals. We identified a total of 68 systemic venous collateral channels, of which 36 (53%) were supracardiac, 12 (18%) cardiac, and 20 (29%) infracardiac in origin. The most common site of origin was the brachiocephalic vein (44%), followed by the left phrenic vein (25%). A longer time from surgery, at 3.3 +/- 3.4 years, was associated with the identification of collaterals having a diameter larger than 4 mm (p < 0.01). The mean pulmonary arterial pressure was higher in those with larger compared to those with smaller collaterals (13.3 +/- 2.8 versus 11.1 +/- 2.0 mmHg, p < 0.01). Coils were used for occlusion of 61 vessels, and a Rashkind occluder for the remaining 7. After exclusion of the patients undergoing simultaneous closure of their fenestration, systemic saturation of oxygen increased from 89 +/- 6% to 95 +/- 3% (p < 0.01). CONCLUSION: Venous collateral channels are common in patients suffering progressive cyanosis in the setting of the Fontan circulation. The collaterals increase in size with time, and are associated with higher pulmonary arterial pressures. Transcatheter treatment is feasible, and results in resolution of cyanosis. Only continuing follow-up will show whether further collateralization occurs in time.

Canada↗
PubMed1991

The permeability of capillaries among the small granule-containing cells in rat superior cervical ganglia: an ultrastructural lanthanum tracer study.

The permeability of blood capillaries associated with small granule-containing (SGC) cells in rat superior cervical ganglia was investigated at ultrastructural level by employing ionic lanthanum as an electron dense tracer. In rat superior cervical ganglia, the majority of blood capillaries were nonfenestrated. Both fenestrated and nonfenestrated capillaries were observed in the area associated with SGC cells. Lanthanum tracer was observed in the luminal surface, the interendothelial cleft and the subendothelial perivascular spaces of both fenestrated and nonfenestrated capillaries associated with SGC cells. The external lamina of the Schwann cell which surrounded the neurons, nerve fibres and SGC cells were clearly delineated by the lanthanum tracer. Furthermore, the perineuronal space, the periaxonal space, and the pericellular space of the SGC cells were readily accessible to the lanthanum ion. The results demonstrated an absence of blood-nerve barrier, blood-ganglionic and blood-SGC cell barrier to the lanthanum ion in the parenchymal area of the SGC cells in rat superior cervical ganglia. It is proposed that lanthanum may pass through the endothelial cells via 1) the fenestrae of fenestrated capillaries, 2) the intercellular junctions of both fenestrated and nonfenestrated capillaries, i.e., a paracellular pathway; and 3) the process of endocytosis/exocytosis, i.e., a transcellular pathway, to reach the subendothelial space and be distributed in the parenchyma of SGC cells in rat superior cervical ganglia.

Animals↗
PubMed1991

[Ruptured intracranial aneurysm combined with multiple cerebral vessel anomalies; a case report].

We report a very rare case of subarachnoid hemorrhage associated with fenestration of the anterior cerebral artery (ACA), the accessory middle cerebral artery (A-MCA) and the duplication of the middle cerebral artery (D-MCA). It seems that this is the first report of these combined intracranial vascular anomalies, although many authors have reported each anomaly in isolation. A 50-year-old male visited a local physician complaining of the sudden onset of a severe pulsating headache. A lumbar puncture showed bloody cerebrospinal fluid, and he was transferred to our institution. An emergency CT scan showed no apparent subarachnoid hemorrhage, but the left internal carotid angiography showed a saccular aneurysm at the origin of the D-MCA. Other anomalies, such as the fenestration of the ACA and the A-MCA, were also apparent during angiography. The ruptured aneurysm was safely clipped on the next day and the patient was discharged with no neurological deficits three weeks after the operation. The incidence of fenestration of the ACA is 0.2% in the angiographic series, and 0.1-7.2% at autopsy. Fenestration of the ACA is thought to be less than that of the vertebral artery. Ever since it was proposed by Teal et al, the term A-MCA has been restricted to an artery that arises from the ACA, and a branch arising from the internal carotid artery has been termed as the D-MCA. These anomalous vessels supply the cortex in the distribution of the middle cerebral artery. The angiographic incidence of A-MCA is about 4%, and six cases of aneurysm located at the origin of the A-MCA have been reported so far.(ABSTRACT TRUNCATED AT 250 WORDS)

Carotid Artery, Internal↗
PubMed1986

Hormonal regulation of capillary fenestrae in the rat adrenal cortex: quantitative studies using objective lens staging scanning electron microscopy.

High magnification studies of the fenestrated capillary endothelium in the zona fasciculata (ZF) of rat adrenal glands were performed using the objective lens stage of an analytical scanning electron microscope (SEM) equipped with a lanthanum hexaboride emitter (LaB6). Resolution of surface substructure of the luminal membrane obtained with specimens decorated with gold/palladium (Au/Pd) was compared with that observed in others sputter coated with tantalum (Ta). High magnification (50,000x) of the fenestrated endothelium demonstrates that tantalum coating of the cryofractured adrenals improves the substructural detail compared to that seen in Au/Pd decorated specimens. The procedures used in specimen preparation, metal deposition and secondary electron imaging (SEI) are described. Quality imaging achieved using the objective lens stage is a result of the elimination of the SE-III component derived from backscattered electrons. Rat adrenals exhibited uniformly patent capillaries. High magnification micrographs of capillary walls were randomly recorded in two morphometric studies of the fenestral content of capillaries in the rat adrenal cortex. Adrenocorticotropic hormone (ACTH), when administered to rats following dexamethasone (DEX) treatment, significantly reduced the fenestrae/micron 2 of endothelial surface and increased the mean size of fenestrae. After hypophysectomy, the number of fenestrae/micron 2 declined over 48 h; within 2 h after ACTH was given to rats hypophysectomized 48 hours earlier, the fenestrae/micron 2 had increased two-fold. These studies indicate that ACTH plays an important role in modulating fenestral content of the capillary endothelium in the adrenal cortex.

Adrenal Cortex↗
PubMed1988

Therapeutic dilemmas in patients with symptomatic polycystic liver disease.

Most reports of the operative treatment of symptomatic polycystic liver disease (PCLD) are anecdotal or consist of only a small subset of patients in an institution's overall experience treating hepatic cysts. We have reviewed our experience with nine consecutive patients with symptomatic PCLD undergoing operative treatment from 1981 to 1987. Indications for operation include chronic abdominal pain (4 patients), cyst infection (2 patients), biliary obstruction (2 patients), inferior vena cava obstruction (2 patients), and symptomatic abdominal distention (2 patients). The average duration of symptoms leading to operation was 7.8 months. Three types of cystic disease were identified based on gross morphology: dominant cystic disease (3 patients), diffuse cystic disease (4 patients), and mixed cystic disease (2 patients). Operations to treat symptomatic PCLD included unroofing and external drainage of infected cysts (2 operations), simple unroofing (1 operation), cyst fenestration alone (4 operations) and fenestration combined with resection (3 operations). Treatment directed at principally dominant cysts (five patients) was associated with resolution of symptoms and low morbidity and mortality. Treatment directed at diffusely cystic disease (four patients) resulted in significant morbidity and mortality including three deaths. Successful surgical treatment of symptomatic patients with PCLD depends on accurate preoperative identification of patients with symptoms related to one or more dominant cysts. In this setting fenestration or simple unroofing of the dominant cyst is safe and effective treatment. By comparison, extensive fenestration with or without hepatic resection in patients with symptoms attributed to a diffusely cystic liver may be associated with unacceptable morbidity and mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

[Morphology of the vascular endothelium of the nasal mucosa].

In the nasal mucosa capillaries with fenestrated and continuous endothelium have been described. Fenestrated capillaries are distributed all over the tunica propria. They are increasing in number subepithelially and close to the nasal glands. Particularly subepithelially the endothelial fenestrations are facing the epithelium. This interesting, morphological feature has already been described as "polar differentiation" in capillaries of other tissues and has been interpreted as a functional differentiation. The same observations could be made in muscularised veins of the nasal mucosa. Only a few fenestrations could be detected in the endothelium of these vessels, but they were all facing the adjacent epithelium. The results indicate that the morphological peculiarities of the vascular endothelium of the nasal blood vessels are transient specialisations of this particular type of cells due to different physiological needs.

Animals↗
PubMed1986

Does the retinal pigment epithelium polarize the choriocapillaris?

Morphometric evaluation of choroidal capillaries from spontaneously hypertensive (SHR) rats with anatomically normal and severely dystrophic retinas reveals a marked polarization of endothelial fenestrations, endothelial cytoplasmic thickness, and endothelial cell nuclei. The mean density of fenestrations per unit endothelial length is greatest and the cytoplasmic thickness and number of nuclei is least in capillary sectors closest to the retinal pigment epithelium (RPE), with a statistically significant, continuous decrease in density of fenestrations and an increase in endothelial thickness and nuclear numbers in sectors progressively farther from the RPE. Abnormal capillaries derived from the retinal circulation and growing within the RPE also have fenestrations, but show no anatomic polarization. These results are consistent with the recently proposed hypothesis that a diffusible, trophic factor, produced by the RPE and secreted from its basal surface, modulates the structure of nearby vascular endothelial cells. However, the endothelial cells themselves probably also influence the structure of the RPE, since complex infoldings of the RPE plasma membrane, identical to those normally present in its basal surface, are also extensively present surrounding the abnormal intra-RPE capillaries.

Animals↗
PubMed1981

Vascular architecture of thymus and lymph nodes, blood vessels, transmural passage of lymphocytes, and cell-interactions.

Postcapillary or high-endothelial venules were preferentially distributed at the cortico-medullary junction of the thymus. In the lymph nodes these venules were located in he paracortical area between cortex and medulla. The venules in the thymus were surrounded by the so-called perivascular spaces, while those in the lymph nodes were not clearly surrounded by this space. The walls of the thymus venules were fenestrated. The reticular sheets surrounding the perivascular spaces were also fenestrated. These fenestrations facilitated the transmural passage of thymocytes through the vessels. In the lymph nodes where the venules had few fenestrations, lymphocytes in transmural passages were usually suspended between the high- endothelial cells. The macrophages were preferentially located in reticular meshes of the paracortical areas, and most of these cells were in contact with lymphocytes. This might indicate that the paracortical areas are the main interaction sites of lymph node lymphocytes and macrophages. Observations on the casted samples are also reported.

Animals↗
PubMed1996

Biomechanics of the thoracolumbar vertebral column of dogs during lateral bending.

OBJECTIVE: To study biomechanical characteristics of the normal and surgically altered canine thoracolumbar vertebral column to determine the effects of surgery and trauma on lateral stability. ANIMALS: The T13-L1 vertebral motion units of 48 mixed-breed dogs were dissected free of surrounding musculature and prepared for biomechanical testing by cross-pinning the vertebral bodies and mounting in polymethylmethacrylate. PROCEDURE: Normal and surgically altered spinal specimens were subjected to lateral bending. The mean slope of the bending moment versus angular displacement curve and the load to failure were compared between treatment groups and significance was determined by the method of least squares (P < 0.05). Specimens were surgically altered by facetectomy, lateral fenestration, diskectomy, and combinations of these procedures. Each specimen was subjected to lateral bending to failure at a rate of 2.5 cm/min in a swing arm bending jig designed to simulate 4-point bending and subject the specimen to pure bending. RESULTS: Only specimens undergoing diskectomy had a significant decrease in slope and load at failure. Unilateral and bilateral facetectomies and fenestration induced a nonsignificant decrease in stiffness, compared with control specimens. CONCLUSIONS: Fenestrations and facetectomies do not appear to increase the risk of injury to the canine thora-columbar spinal cord during lateral bending. CLINICAL RELEVANCE: Fenestrations and facetectomies, as used in routine laminectomies, may be performed without concern for significant destabilization of the spine in lateral bending; however, it is possible that thoracolumbar spinal fractures involving only the vertebral body may significantly destabilize the spine in all modes of bending.

Animals↗
PubMed1998

[Treatment and diagnosis of middle fossa arachnoid cyst: ventriculofiberscopy and cine-MRI].

The treatment of intracranial arachnoid cysts in controversial regarding its surgical indication and operative procedures. Conventional surgical approaches such as fenestration, membranectomy, and shunting operation are invasive. Also CT cisternography and/or RI cisternography are invasive, when it has been performed to evaluate the possible CSF communications between the arachnoid cyst and subarachnoid space. Between July 1994 and February 1997, 10 patients with intracranial middle fossa arachnoid cysts were treated with a newly developed ventriculofiberscope which is characterized by splendid mechanical flexibility and high resolution. The cine-MRI, which is a non-invasive diagnostic tool, is used to evaluate the CSF circulation around the cyst fenestration. The patients' ages ranged from 4 months to 10 years, with a mean of 4.46 years. The cyst locations were left middle fossa (9), and right (1). Eight patients presented with macrocrania, 4 with developmental delay, three with seizure, two with headache, and one with subdural hematoma. The patients were preoperatively evaluated by means of MRI and cine-MR images. In all patients ventriculofiberscopic procedures including cyst fenestration, membranous dissection, cyst puncture and shrivelling were successfully performed. Postoperative MR and cine-MR studies have shown reduction of the cyst size and appropriate CSF circulation. Neuroendoscopic procedures seem to be the choice for children with arachnoid cysts and the ventriculofiberscope proved to be very useful not only for cyst fenestration but also for cyst dissection. In addition, the non-invasive cine-MR studies are useful for long follow-up at OPD.

Arachnoid Cysts↗