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[Torkildsen's operation--50 years later].

T Lundar1, P Nakstad

  • 1Nevrokirurgisk avdeling, Rikshospitalet, Oslo.

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|February 20, 1990
PubMed
Summary

The Torkildsen procedure, a ventriculocisternostomy, offers a viable alternative for treating non-communicating hydrocephalus. This historical technique avoids common shunt complications and provides satisfactory long-term results.

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Area of Science:

  • Neurosurgery
  • Pediatric Neurosurgery
  • Hydrocephalus Management

Background:

  • Standard ventriculoatrial and ventriculoperitoneal shunts have been primary treatments for hydrocephalus for decades.
  • Advancements in imaging like CT and MRI have reduced the differentiation between communicating and non-communicating hydrocephalus.
  • Most patients treated with shunts become lifelong shunt-dependent.

Observation:

  • The Torkildsen procedure (ventriculocisternostomy) was re-evaluated in eight patients with proven aqueduct obstruction over a two-year period.
  • Diagnosis was confirmed using ventriculography or combined CT and magnetic resonance imaging.
  • Five of these patients achieved satisfactory long-term outcomes with the Torkildsen procedure.

Findings:

  • The Torkildsen procedure resulted in satisfactory long-term outcomes in 5 out of 8 patients with non-communicating hydrocephalus.
  • This surgical approach does not typically lead to severe cardiopulmonary complications.
  • Overdrainage, a common issue with shunts, is also avoided with the Torkildsen procedure.

Implications:

  • The Torkildsen procedure remains a valuable alternative to standard shunts for specific hydrocephalus cases.
  • It offers a potentially safer, less complicated long-term management option for non-communicating hydrocephalus.
  • Revisiting historical neurosurgical techniques can provide effective solutions for current clinical challenges.

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