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Fig. 4 | Egyptian Journal of Neurosurgery

Fig. 4

From: Traffic light alarming signs are indispensable prerequisites for fruitful endoscopic third ventriculostomy

Fig. 4

Neuroendoscopic video-captured images showing aneurysm like structure (AnLS) in 2 different neonates: (AC) in a 3-day-old male neonate. A Evidence of post-hemorrhagic brown pigmentations are seen along the lateral/third ventricular walls (lower inset) and inside the aqueduct of sylvius (upper inset). The III-VT structures (including mamillary bodies “MB”) are seen before navigating the foramen of Monro. The AnLS (black star) can be seen along the choroidal vessels and vessels around the foramen of Monro (white stars) = yellow sign. B Showing the relationship between the choroid plexus (CP), AnLS (black star) and related vessels (white stars). C visual confirmation of the basal cistern showing the dorsum sellae (DS), basilar atery (BA) and its perforators and major branches (white arrows) surrounded by our openings in the thin/transparent Liliequist membrane (LM). (DH) in a 28-day-old male neonate. D Evidence of post-hemorrhagic brown pigmentations (= yellow sign) are seen along the lateral ventricular walls and choroid plexus and Decq forceps ( white*) opened parallel to the clivus to do an ETV stoma (lowr right inset). The III-VT structures are seen before navigating the foramen of Monro. E, F, G visual confirmation of the basal cistern showing the clivus (CL), basilar artery (BA), Posterior communicating artery (Pcom) and a thick dense Liliequist membrane (LM) (= red sign). F Stepwise opening the thick/dense LM with scissors (black*). G The abducent nerve (VI) was finally identified entering the Drello’s canal (white arrow). H At the end CPC was added to both agument the ETV and, to elimenate the AnLS feeders which was seen along the choroid plexus inside the temporal horn (black arrow)

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