Endoscopic third ventriculostomy for hydrocephalus secondary to central nervous system infection or intraventricular hemorrhage in children.

Abstract:

OBJECTIVE:We review our experience of endoscopic third ventriculocisternostomy (ETV) in children with hydrocephalus from central nervous system (CNS) infection or intraventricular hemorrhage to better elucidate success rates and predictors of success in these children. METHODS:We performed a retrospective review of 12 children less than 21 years of age with ETV treated from 1999 to 2002 with a minimum follow-up of 12 months. Children selected for surgery had been diagnosed with hydrocephalus from perinatal germinal matrix hemorrhage or CNS infection and had neuroimaging consistent with obstruction of the aqueduct, fourth ventricular outlets or both at the time of ETV. Charts and imaging studies were reviewed to determine clinical outcomes and predictors of successful ETV. An ETV was deemed successful if the child did not require placement or replacement of a ventriculoperitoneal shunt. RESULTS:Thirteen ETV were performed in 12 patients (7 boys and 5 girls; mean age 9.2 years, range 3.8-21 years), with an overall success rate of 60% for those with CNS infections and 71% for those with perinatal intraventricular hemorrhage at initial presentation. There were no significant complications from the procedure. CONCLUSIONS:ETV is a safe procedure, which in carefully selected children with etiologies of hydrocephalus thought to be 'communicating' in nature carries a satisfyingly high success rate. Further application and study of this modality in larger groups of patients with these causes of hydrocephalus is warranted.

journal_name

Pediatr Neurosurg

journal_title

Pediatric neurosurgery

authors

Smyth MD,Tubbs RS,Wellons JC 3rd,Oakes WJ,Blount JP,Grabb PA

doi

10.1159/000072871

keywords:

subject

Has Abstract

pub_date

2003-11-01 00:00:00

pages

258-63

issue

5

eissn

1016-2291

issn

1423-0305

pii

72871

journal_volume

39

pub_type

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