Endoscopic Third Ventriculostomy for Obstructive Hydrocephalus due to Intraventricular Hemorrhage

Obaid, Sami; Weil, Alexander G.; Rahme, Ralph; Bojanowski, Michel W.

doi:10.1055/s-0034-1382778

Cited by 19 publications

(35 citation statements)

References 31 publications

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“…Obaid et al (23) performed a retrospective analysis of 78 consecutive patients who underwent ETV at their institution. They identified 17 consecutive patients who underwent ETV for obstructive hydrocephalus associated with IVH.…”

Section: Discussionmentioning

confidence: 99%

Smartphone‑assisted endoscopic surgery via Kocher's point for intraventricular hemorrhage caused by thalamic hemorrhage: A comparison with external ventricular drainage

et al. 2019

Exp Ther Med

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The aim of the present study was to investigate the efficacy of endoscopic surgery via a Kocher point approach for intraventricular hemorrhage (IVH) caused by thalamic hemorrhage (TH), in comparison with external ventricular drainage (EVD). Between January 2016 and August 2017, a total of 40 patients with IVH caused by TH were enrolled. The patients were assigned to an EVD group and an endoscopic surgery group in a non-randomized manner. The pre-operative characteristics recorded included age, pre-operative Glasgow Coma Scale (GCS) score, hemorrhage volume, length of neuro-intensive care unit stay and Graeb score of IVH. Outcomes included the GCS score at 2 weeks after surgery, 30-day and 90-day mortality rates, modified Rankin scale at 6 months after ictus and ventriculo-peritoneal (VP) shunt rate. The baseline characteristics were not significantly different between the two groups. The VP shunt rate in the EVD group was significantly higher compared with that in the endoscopic surgery group (50.0 vs. 15.0%; P= 0.02; odds ratio, 5.7). In conclusion, smartphone-assisted endoscopic surgery via Kocher's point is feasible and safe, and significantly reduces permanent shunt dependency for IVH caused by TH.

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Section: Discussionmentioning

confidence: 99%

Smartphone‑assisted endoscopic surgery via Kocher's point for intraventricular hemorrhage caused by thalamic hemorrhage: A comparison with external ventricular drainage

et al. 2019

Exp Ther Med

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“…Considering the advantage of excellent visualization and illumination, neuroendoscopes allow neurosurgeons to navigate around structures, especially in CSF-filled ventricular system, which made ETV gradually the primary treatment for obstructive hydrocephalus. [1,2] Meanwhile, as experience grows, various studies suggested that complications of ETV increasingly reported and affected the prognosis of patients. [3,4] The complications of the ETV was about 2% to 15%, [5] which included CSF leakage, intracranial infection, intracranial hemorrhage, subdural effusion, postoperative fever, subcutaneous effusion, and so on.…”

Section: Discussionmentioning

confidence: 99%

“…[1,2] With the wide application of neuroendoscope, complications also gradually increased. [3,4] Cerebrospinal fluid (CSF) leak and subcutaneous CSF collection were one of the most common complications of ETV.…”

Section: Introductionmentioning

confidence: 99%

Keyhole approach in the neuroendoscopic treatment for hydrocephalus

Cai

Zhang²,

Wang³

et al. 2017

Medicine

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The aim of the study was to explore keyhole approach and dura suture in the neuroendoscopic treatment for hydrocephalus.Twelve cases of hydrocephalus patients who were treated with neuroendoscope by this approach were analyzed retrospectively from April 2015 to April 2016 in our department. The basic steps of this procedure was using drill and milling cutter to form a small bone flap instead of burr hole, and then making a cruciate incision on the dura. After endoscopic third ventriculostomy or endoscopic third ventriculostomy + ventriculocystostomy finished, dura was sutured and the bone flap was reset.All 12 patients could suture dura effectively, and no cerebrospinal fluid leak and subcutaneous cerebrospinal fluid collection happened; symptoms of hydrocephalus were also improved. Moreover, during the operation, we found this approach could suspend dura, and avoid the cerebral sulcus and cortical coarse vein effectively, which could reduce the risk of intracranial hemorrhage. In addition, we found this approach could increase the reachable range of the neuroendoscope significantly.Keyhole approach can suture dura and avoid the cerebral sulcus and cortical coarse vein effectively, increase the indications, and reduce complications of neuroendoscope. So, this approach has clinical values and can be used in hydrocephalus.

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“…In group B (adult group), however, blood entering the SAS after cerebral hemorrhage is the most likely cause for SAS obstruction. 10 As early as 1932, Dandy cautioned that before performing a third ventriculostomy for obstructive hydrocephalus, it is necessary to establish the patency of distal subarachnoid pathways. The difficulty in preoperatively detecting the presence of coexisting obstruction in the basilar cisterns or in the subarachnoid space of the surface may account for the 25 to 40% failure rate reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Experience with Lumbar Puncture Following Endoscopic Third Ventriculostomy for Obstructive Hydrocephalus

Kang

Zhu

et al. 2016

J Neurol Surg A Cent Eur Neurosurg

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The increase in intracranial pressure (ICP) in some patients in the immediate postoperative period following endoscopic third ventriculostomy (ETV) is not well understood. This study explored the effect of lumbar puncture following ETV for obstructive hydrocephalus on outcome. A total of 145 patients with obstructive hydrocephalus underwent ETV between 2009 and 2014. Following ETV, all patients underwent lumbar puncture on postoperative days 1 and 3. In 106 patients, ICP returned to normal levels accompanied by symptom relief. In 39 patients, ICP remained high on postoperative days 3, and lumbar puncture was continued every alternate postoperative day for 11 days. ICP always returned to normal. These 39 patients were divided into two groups for analysis: group A (age < 18 years) and group B (age ≥ 18 years). Peak values of ICP for groups A and B were recorded on days 3 and 5, respectively. Our study suggests an important role for postoperative lumbar puncture in ensuring successful treatment results after ETV. In most of the symptomatic patients with obstructive hydrocephalus, lumbar puncture appears to contribute to rapid ICP normalization, to alleviation of symptoms, and prevention of complications.

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Endoscopic Third Ventriculostomy for Obstructive Hydrocephalus due to Intraventricular Hemorrhage

Cited by 19 publications

References 31 publications

Smartphone‑assisted endoscopic surgery via Kocher's point for intraventricular hemorrhage caused by thalamic hemorrhage: A comparison with external ventricular drainage

Smartphone‑assisted endoscopic surgery via Kocher's point for intraventricular hemorrhage caused by thalamic hemorrhage: A comparison with external ventricular drainage

Keyhole approach in the neuroendoscopic treatment for hydrocephalus

Experience with Lumbar Puncture Following Endoscopic Third Ventriculostomy for Obstructive Hydrocephalus

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