Endoscopic third ventriculostomy in the management of obstructive hydrocephalus: an outcome analysis

Feng, Huiyu; Huang, Gui Chao; Liao, Xiaoling; Fu, Kai; Tan, Haibin; Peng, Hong; Cheng, Yong; Liu, Weidong; Zhao, Dewei

doi:10.3171/jns.2004.100.4.0626

Cited by 190 publications

(127 citation statements)

References 65 publications

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“…The success of ETV is generally defined by the clinical improvement and VPS independence, and success rates vary from 50 to 90% [42][43][44]. Beems and Grotenhuis [9] reported one of the largest series of patients (339) and achieved a success rate of 76%.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic third ventriculostomy in the management of hydrocephalus: Outcome analysis of 168 consecutive procedures

Salvador

Oliveira

Pereira

et al. 2014

Clinical Neurology and Neurosurgery

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a b s t r a c tBackground: Endoscopic third ventriculostomy (ETV) is the treatment of choice for obstructive hydrocephalus, but the outcome is still controversial in terms of age and aetiology. Methods: Between 1998 and 2011, 168 consecutive procedures were performed in 164 patients, primarily children (56% < 18 years of age and 35% < 2 years of age). The causes of obstructive hydrocephalus included tumoural pathology, Chiari malformation, congenital obstruction of the aqueduct, post-infectious and post-haemorrhagic membranes, and ventriculo-peritoneal shunt (VPS) malfunctions. Successful ETV was defined by the resolution of symptoms and the avoidance of a shunt. Results: ETV was successful in 75.6% of patients, but 19% of the patients required VPS in the first month after ETV, and 5.4% required a VPS more than one month after ETV. Four patients were ultimately submitted for second ETVs. In this series, no major permanent morbidity or mortality was observed. Conclusions: ETV is a safe procedure and an effective treatment for obstructive hydrocephalus even following the dysfunction of previous VPSs and in children younger than two years.

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Section: Discussionmentioning

confidence: 99%

Endoscopic third ventriculostomy in the management of hydrocephalus: Outcome analysis of 168 consecutive procedures

Salvador

Oliveira

Pereira

et al. 2014

Clinical Neurology and Neurosurgery

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“…17) RI cisternography predicted shunt responsiveness less accurately than repeated lumbar CSF tap test or lumbar external CSF drainage, 61) and the use of RI cisternography did not add any additional information. 16) Because of the invasiveness and low diagnostic accuracy of CT or RI cisternography, it is not necessary for the diagnosis of iNPH (Recommendation grade C2); however, it may be useful in identifying obstructions in the circulation of CSF.…”

Section: -C Cisternographymentioning

confidence: 99%

“…A few recent reports have described improved symptoms when ETV has been used to treat iNPH, 16,17,29,41,59) but imaging findings from individual cases are inconclusive. They include cases of so-called``functional aqueductal stenosis'' in which the cerebral aqueduct is patent, but inferior displacement of the floor of the third ventricle is evident.…”

Section: -A-iii Endoscopic Third Ventriculostomy (Etv)mentioning

confidence: 99%

Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus: Second Edition

Mori

Ishikawa

Kato

et al. 2012

Neurol. Med. Chir.(Tokyo)

557

723

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Among the various disorders manifesting dementia, gait disturbance, and urinary incontinence in the elderly population, idiopathic normal pressure hydrocephalus (iNPH) is becoming of great importance. After the publication of the first edition of the Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus in 2004 (the English version was published in 2008), clinical awareness of iNPH has risen dramatically, and the number of shunt surgeries has increased rapidly across Japan. Clinical and basic research on iNPH has increased significantly, and more high-level evidence has since been generated. The second edition of the Japanese Guidelines was thus published in July 2011, to provide a series of timely evidence-based recommendations related to iNPH. The revision of the Guidelines has been undertaken by a multidisciplinary expert working group of the Japanese Society of Normal Pressure Hydrocephalus in conjunction with the Japanese Ministry of Health, Labour and Welfare research project on``Studies on the epidemiology, pathophysiology, and treatment of normal pressure hydrocephalus.'' This English version of the second edition of the Guidelines was made to share these ideas with the international community and to promote international research on iNPH.

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“…Poor cognitive function and visual loss are potential complications in infants with untreated hydrocephalus. Additionally, consequential impairments can also persist after treatment and interfere in the patient's development during a crucial time of growth [3][4][5]. Brain computed tomography and MRI are typically used to confirm the extent of the condition and its combined anomalies.…”

Section: Discussionmentioning

confidence: 99%

A New-born with Severe Hydrocephalus and Myelomeningocele Associated with Maternal Antiepileptic Medication: A Case Report

Nam¹,

Lee²,

Jun³

2017

J Gen Pract

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The possible teratogenic effects of maternal antiepileptic drugs (AEDs) on the development of the fetus are of major concern. The fetal risks imposed by these drugs must be weighed against the risks associated with untreated maternal epilepsy not being treated. Here, we describe an infant with a neural tube defect caused by AEDs prescribed to the mother during her pregnancy. A female infant was delivered by means of cesarean section after 37 +6 weeks of gestation. Her 21-year-old mother had been diagnosed with epilepsy at 2 years of age, following brain surgery performed for a traffic accident injury. Since the age of 6 years, the mother had been medicated with lamotrigine (Lamictal ® ), levetiracetam (Keppra ® ), and valproate (Depakote ® ). At birth, the baby exhibited pallor, severe macrocephaly, a large anterior fontanelle (4 cm × 4 cm), and sutural widening. On her lower back, there was a 3 cm open spinal dysraphism exposing nervous tissue. On the 11 th postnatal day, a ventriculo-peritoneal shunt was placed and a myelomeningocele removal operation was performed. After this operation, the head circumference decreased from 44.0 cm to 35.8 cm, and the post-operative period was uneventful. The patient was discharged on the 24 th day. Several case reports and studies have reported that valproate or multi-antiepileptic medication that contains valproate increased the risk of neural tube defects in the offspring. For women of childbearing age who use AEDs, clinicians should review pregnancy risk regularly and consider adjusting medication whenever possible. Additionally, while examing newborns with neural tube defects, clinicians should review prenatal maternal medication history thoroughly.

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Endoscopic third ventriculostomy in the management of obstructive hydrocephalus: an outcome analysis

Cited by 190 publications

References 65 publications

Endoscopic third ventriculostomy in the management of hydrocephalus: Outcome analysis of 168 consecutive procedures

Endoscopic third ventriculostomy in the management of hydrocephalus: Outcome analysis of 168 consecutive procedures

Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus: Second Edition

A New-born with Severe Hydrocephalus and Myelomeningocele Associated with Maternal Antiepileptic Medication: A Case Report

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