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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Minim+Invasive+Neurosurg
2011 ; 54
(5-6
): 243-6
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"Colossal" breakthrough: the callosal puncture as a precursor to third
ventriculostomy
#MMPMID22278787
Chesler DA
; Pendleton C
; Jallo GI
; Quiñones-Hinojosa A
Minim Invasive Neurosurg
2011[Oct]; 54
(5-6
): 243-6
PMID22278787
show ga
BACKGROUND: In 1908, Anton and von Bramann proposed the Balkenstich method, a
corpus callosum puncture which created a communication between the ventricle and
subarachnoid space. This method offered the benefit of providing continuous CSF
diversion without the implantation of cannula or other shunting devices, yet it
received only slight reference in the literature of the time. It remained a novel
and perhaps underutilized approach at the time Cushing began expanding his
neurosurgical practice at the Johns Hopkins Hospital. MATERIALS AND METHODS:
Following IRB approval, and through the courtesy of the Alan Mason Chesney
Archives, the surgical records of the Johns Hopkins Hospital for the period
1896-1912 were reviewed. Patients operated upon by Harvey Cushing were selected.
RESULTS: 7 patients underwent puncture of the corpus callosum for treatment of
hydrocephalus. 6 patients were treated for obstructive hydrocephalus secondary to
presumed intracranial lesions. 1 patient was treated for congenital
hydrocephalus. CONCLUSION: The series reported here documents Cushing's early use
of the corpus callosum puncture to divert CSF in patients with obstructive
hydrocephalus secondary to intracranial tumors, as well as an attempt to use the
procedure in a pediatric patient with congenital hydrocephalus. Notably, 3
patients developed new onset left-sided weakness post-operatively, possibly due
to retraction injury upon the supplementary motor intra-operative manipulations.