A NEW METHOD FOR TRANSCUTANEOUS COAXIAL NEUROENDOSCOPY

A new method of direct endoscopy of the subarachnoid space and a major part of the ventricles of the human central nervous system is present ed. The technique was developed on more than 100 human bodies with the help of a bronchoscope. Percutaneous entry into the subarachnoidal sp ace is performed from the dorsal side between vertebrae L5 and S1. The endoscope can be moved along the spinal cord on both the dorsal and t he ventral side. From the dorsal side of spinal cord the cerebello-med ullary cistern can be reached. The fourth ventricle is entered through the median aperture and then the third ventricle through the cerebral aqueduct. From the ventral side of the spinal cord the posterior cran ial fossa is reached and the large arteries and the cranial nerves can be inspected. The main conclusion of the present report is that the s ubarachnoid space seems to be large enough for a coaxial exploration w ith a 3-5 mm diameter fibroscope if the investigator possesses a good knowledge of the subarachnoid anatomy. The technique provides new appr oaches in research and possibilities of clinical investigations and th erapy.