Other Operations

Walter Dandy, with Blackfan, identified the choroid plexus as the primary source of CSF production. On physiologic principles, in 1919, Dandy introduced choroid plexectomy as a treatment for hydrocephalus, in which the choroid plexus was ablated by cautery. This was initially performed as an open operation with a very high mortality rate but later was performed endoscopically by himself, Scarff, and others with a success rate of 70-80% and a mortality rate of approximately 15%. This procedure eventually fell out of favor with the subsequent discovery of significant extrachoroidal sources of CSF as well as the introduction of simpler shunting procedures.

Dandy also introduced open procedures for creating openings in the third ventricle into the basal cisterns on the undersurface of the brain. These were again developed into endoscopic procedures with success and mortality rates similar to those for choroid plexectomy. Patient selection for these was problematic before the modern imaging era because the optimal patient was one who had an obstruction in the aqueduct of Sylvius, which was the outflow tract for the third ventricle. There is a resurgence of interest in this procedure because of more sophisticated endo-scopic techniques and equipment as well as the availability of appropriate imaging to select the right candidates.

Understanding And Treating Autism

Understanding And Treating Autism

Whenever a doctor informs the parents that their child is suffering with Autism, the first & foremost question that is thrown over him is - How did it happen? How did my child get this disease? Well, there is no definite answer to what are the exact causes of Autism.

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