Intraoperative cone-beam computed tomography for catheter placement verification in pediatric hydrocephalus: technical note

Matthias Krause* (First author), Jasmina Lagumdzija (Co-author), Simon Enzinger (Co-author), Joern Wittig (Co-author), Alexander Gaggl (Co-author), Roman P. Metzger (Co-author), Christoph J. Griessenauer (Last author)

*Corresponding author for this work

Research output: Contribution to journalOriginal Articlepeer-review

Abstract

Ventriculoperitoneal (VP) shunt placement, essential for managing hydrocephalus, often risks catheter malpositioning, especially in patients with small ventricles. We present a novel technique combining neuronavigation with intraoperative cone-beam computed tomography using the BrainLab system and Loop-X mobile imaging unit. This approach enables real-time verification of catheter placement by integrating preoperative MRI data with intraoperative CT imaging. In a 12-year-old boy with therapy-refractory idiopathic intracranial hypertension, neuronavigation was guided by the BrainLab Skull Fix and Cushing canula, ensuring precise catheter insertion into the right frontal horn. Post-placement, Loop-X facilitated immediate verification of the catheter's trajectory and positioning, corroborated by postoperative MRI. This technique demonstrated high precision and minimized radiation exposure, emphasizing its utility in reducing revision rates due to suboptimal catheter placement.
Original languageEnglish
Pages (from-to)3813-3816
Number of pages4
JournalCHILDS NERVOUS SYSTEM
Volume40
Issue number11
Early online dateSept 2024
DOIs
Publication statusPublished - Nov 2024

Keywords

  • Cone-beam computed tomography
  • Intraoperative navigation
  • Pediatric neurosurgery
  • Pseudotumor cerebri
  • Shunt placement

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