Endoscopic Intraventricular Surgery for Treatment of Hydrocephalus and Loculated CSF Space in Children Less than One Year of Age

Abstract

Controversy exists regarding whether children under 1 year of age have a higher risk of treatment failure after neuroendoscopic procedures for the treatment of hydrocephalus than older children. We retrospectively reviewed the surgical management and clinical outcome of 15 infants who underwent neuroendoscopic surgery for the treatment of CSF space loculation and hydrocephalus. We performed 8 third ventriculostomies, 3 endoscopic arachnoid cyst fenestrations, 2 aqueductoplasties, 1 septostomy and in 1 patient, three endoscopic fenestrations for isolated ventricular compartments. Two of the third ventriculostomies, 1 of the aqueductoplasties and the 1 septostomy failed, and these patients underwent placement of a ventriculoperitoneal shunt. In all other patients, symptoms and signs related to hydrocephalus or CSF space loculation were relieved effectively after the endoscopic procedure. We conclude that neuroendoscopy presents an effective alternative for the treatment of hydrocephalus and CSF loculation in infants less than 1 year of age.

A large arachnoid cyst of the lateral ventricle extending from the supracerebellar cistern—case report

“…Among these 22 lateral ventricular arachnoid cysts, there were 7 cases of pediatric lateral ventricular arachnoid cysts, all of which occurred in males compared with the authors' case who was female [2,6,8,12,24].…”

“…In the review of 7 pediatric arachnoid cyst cases of the lateral ventricular arachnoid cyst in the literature, the patients were treated with cystoperitoneal shunt in 1 case, fenestration in 2 cases, fenestration and shunt in 2 cases, endoscopic fenestration in 1 case, endoscopic fenestration and shunt in 1 case, and shunt and open removal in 1 case. If the authors' case is included, the combined approach totals 5 cases [2,6,8,12,24]. In the literature that describes 15 adult arachnoid cysts of the lateral ventricle, the patients were treated with open cyst removal in 2 cases, open fenestration or partial cyst removal in 7 cases, endoscopic fenestration in 2 cases, fenestration and shunt in 2 cases, and no treatment in 2 cases [3,5,7,9,11,13,17,[21][22][23].…”

Neurosurgery Education and Development program to treat hydrocephalus and to develop neurosurgery in Africa using mobile neuroendoscopic training

“…A number of studies of ETV in young infants (< 1 year of age) have been published since 1990. 3,7,10,12,22 In patients less than 1 year of age, Javadpour et al 10 observed a success rate of 48%, with the best outcomes in patients with congenital aqueduct stenosis (71%). Koch and Wagner 12 reported a 31% success rate of ETV, whereas Warf, 22 whose surgeries included choroid plexus cauterization, reported a 47% success rate.…”

Navigated endoscopic surgery for multiloculated hydrocephalus in children

“…2,15,21,28 With the broadening use of neuroendoscopy, it became used in the setting of multiloculated hydrocephalus. 9,10,19,24,25,32,39 The advantage of using an endoscope for visualization in contrast to open cyst fenestration is obvious because it minimizes the size of skull opening, brain retraction and trauma, and facilitates deep access mainly through preformed and existing cavities. One advantage in endoscopic shunt placement is that the surgeon has intraoperative control of the position of the inserted catheters, thereby potentially decreasing the risk of malpositioning.…”