Noninvasive Thermal Evaluation of Ventriculoperitoneal Shunt Patency and Cerebrospinal Fluid Flow Using a Flow Enhancing Device.

Background: While a noninvasive flow determination would be desirable in the diagnosis of cerebrospinal fluid shunt malfunction, existing studies have not yet defined a role for thermal flow detection.

Objective: To evaluate a revised test protocol using a micropumper designed to transiently enhance flow during thermal testing to determine whether thermal detection of flow is associated with progression to shunt revision surgery.

Methods: Eighty-two unique tests were performed in 71 shunts.

Transtentorial transcollateral sulcus approach to the ventricular atrium: an endoscope-assisted anatomical study.

OBJECTIVE Conventional approaches to the atrium of the lateral ventricle may be associated with complications related to direct cortical injury or brain retraction. The authors describe a novel approach to the atrium through a retrosigmoid transtentorial transcollateral sulcus corridor. METHODS Bilateral retrosigmoid craniotomies were performed on 4 formalin-fixed, colored latex-injected human cadaver heads (a total of 8 approaches).

Algorithms for Design of Continuum Robots Using the Concentric Tubes Approach: A Neurosurgical Example.

We propose a novel systematic approach to optimizing the design of concentric tube robots for neurosurgical procedures. These procedures require that the robot approach specified target sites while navigating and operating within an anatomically constrained work space. The availability of preoperative imaging makes our approach particularly suited for neurosurgery, and we illustrate the method with the example of endoscopic choroid plexus ablation.

Robotic Neuro-Endoscope with Concentric Tube Augmentation.

Surgical robots are gaining favor in part due to their capacity to reach remote locations within the body. Continuum robots are especially well suited for accessing deep spaces such as cerebral ventricles within the brain. Due to the entry point constraints and complicated structure, current techniques do not allow surgeons to access the full volume of the ventricles.

Evaluation of the ShuntCheck noninvasive thermal technique for shunt flow detection in hydrocephalic patients.

Background: ShuntCheck (Neuro Diagnostic Devices, Inc., Trevose, Pennsylvania) is a new device designed to detect cerebrospinal fluid (CSF) flow in a shunt by sensing skin temperature downstream from a region of CSF cooled by an ice cube.

Objective: To understand its accuracy and utility, we evaluated the use of this device during routine office visits as well as during workup for suspected shunt malfunction.