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Unlabelled: Hydrocephalus is a disorder of abnormal accumulation of cerebrospinal fluid in the intracranial space, usually in the cerebral ventricles. The number of patients reaching reproductive age and intending to become pregnant has increased in recent years because of treatment advances. An implanted shunt is usually introduced into the abdominal cavity (ventriculoperitoneal shunt). Numerous changes occur during pregnancy, mainly increased accumulation of water, increased intracranial cerebrospinal fluid volume and increased intra-abdominal pressure as a result of the growing uterus. These changes contribute to increased incidence of complications during pregnancy and childbirth. Therefore, it is necessary to make a preconception exam and specify pregnancy management, a suitable method of childbirth and dealing with potential complications. Multidisciplinary care is mandatory with the dominant cooperation of obstetricians and neurosurgeons who should be also available during the delivery when needed. Possible shunt malfunction is necessary to diagnose properly and in time and solve it individually, taking into account the overall and neurological status of the patient and gestational age. The presence of a shunt does not affect pregnancy and vaginal delivery is considered by most authors as the first option. Primary cesarean section is preffered in patients with obstructive hydrocephalus or rapid deterioration in the case of shunt malfunction. Epidural anesthesia or general, eventually spinal anesthesia are recommended., Keywords: hydrocephalus, shunt, ventriculoperitoneal shunt, ventriculoatrial shunt, endoscopy, endoscopic third ventriculostomy, pregnancy.

Idiopathic intracranial hypertension is a disorder that results from an increase of intracranial pressure with unknown cause. A single measurement of intracranial pressure only provides data at one given point in time. Therefore, telemetric monitoring of intracranial pressure was performed in a patient with fluctuating headache and significantly impaired vision, which together accounted for 226.2 hours of recording during normal daily activities. Elevated intracranial pressure was not found during monitoring, so we did not indicate the patient for shunt surgery.

Introduction: Implantation of a ventriculoperitoneal shunt is a standard procedure in the treatment of hydrocephalus. Shunt malfunction can be due to various causes, such as failure of the peritoneal (distal) part of the shunt with a frequency of 5% to 47%., Objective: The aim of this study was to compare laparoscopic and laparotomic techniques for implantation of a ventriculoperitoneal shunt., Material and Methods: We considered a cohort of 304 patients with hydrocephalus, acquired during a 10-year period, who underwent surgical intervention at the Neurosurgical and Surgical Clinics of the University Hospital Brno., Results: The 304 patients underwent a total of 392 operations, of which 67 (17.1%) were performed using a laparoscopic approach and 325 (82.9%) using a laparotomic approach. In the laparotomy group, 59 (18.2%) interventions were repeated due to complications of the peritoneal part of the shunt, while in the laparoscopy group revisions accounted for only 3 cases (4.5%)., Conclusions: The laparoscopic technique significantly reduces the risk of complications of the peritoneal part of the shunt, and thus the overall complications associated with the implantation of the ventriculoperitoneal shunt. Laparoscopy is indicated in the case of migration of the peritoneal catheters into the abdominal cavity and is also very helpful in revisions in the case of malfunction of the peritoneal part of the shunt or in the case of previous abdominal surgery. It can explain the anatomical conditions in the abdominal cavity and it is able to treat any incidental pathology.

The lesions arising in the popliteal fossa are varied. We report two different lesions related to the peroneal nerve that presented with neurologic symptoms. Both were initially treated at surgical department with insufficient diagnostics and finally required a neurosurgical operation. We emphasize performing complete diagnostics that may avoid unnecessary burden for the patient and healthcare personnel. Patients with proven intimate relation of the lesion to nerve structures in the popliteal fossa should be referred to neurosurgical department.

The article deals with the orbitozygomatic approach used in the treatment of pathological processes located in the anterior, medial and superior third of the posterior cranial fossa with special attention paid to suprasellar lesions. It presents a step-by-step guide to the surgical procedure, including potential complications. Furthermore, various modifications of the orbitozygomatic approach are discussed and several references from other authors are quoted with respect to the comparison of different approaches based on quantification criteria. The orbitozygomatic approach is the method of choice in the treatment of suprasellar lesions, in particular in the case of voluminous expansion. It allows for more radical resection, because the operational field is more extensive and operation in deep intracranial structures is easier.