Endoscopic Third Ventriculostomy

Jones, Robert; Stening, W. A.; Brydon, M.

doi:10.1227/00006123-199001000-00012

Cited by 303 publications

(118 citation statements)

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“…ETV has progressed greatly through the refinement of neuroendoscopic techniques and endoscopic optics since Sayers and Kosnik (1976) first described the use of percutaneous ventriculostomy in patients with hydrocephalus who had previously undergone shunt placement and Jones et al 5,17) published a series of patients treated with ETV for the first time.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Third Ventriculostomy in Patients with Shunt Malfunction

Lee

Kong

Seol

et al. 2011

J Korean Neurosurg Soc

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Objective : This paper presents data from a retrospective study of endoscopic third ventriculostomy (ETV) in patients with shunt malfunction and proposes a simple and reasonable post-operative protocol that can detect ETV failure. Methods : We enrolled 19 consecutive hydrocephalus patients (11 male and 8 female) who were treated with ETV between April 2001 and July 2010 after failure of previously placed shunts. We evaluated for correlations between the success rate of ETV and the following parameters : age at the time of surgery, etiology of hydrocephalus, number of shunt revisions, interval between the initial diagnosis of hydrocephalus or the last shunt placement and ETV, and the indwelling time of external ventricular drainage. Results : At the time of ETV after shunt failure, 14 of the 19 patients were in the pediatric age group and 5 were adults, with ages ranging from 14 months to 42 years (median age, 12 years). The patients had initially been diagnosed with hydrocephalus between the ages of 1 month 24 days and 32 years (median age, 6 years 3 months). The etiology of hydrocephalus was neoplasm in 7 patients; infection in 5; malformation, such as aqueductal stenosis or megacisterna magna in 3; trauma in 1; and unknown in 3. The overall success rate during the median follow-up duration of 1.4 years (9 days to 8.7 years) after secondary ETV was 68.4%. None of the possible contributing factors for successful ETV, including age (p=0.97) and the etiology of hydrocephalus (p=0.79), were statistically correlated with outcomes in our series. Conclusion : The use of ETV in patients with shunt malfunction resulted in shunt independence in 68.4% of cases. Age, etiology of hydrocephalus, and other contributing factors were not statistically correlated with ETV success. External ventricular drainage management during the immediate post-ETV period is a good means of detecting ETV failure.

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Section: Discussionmentioning

confidence: 99%

Endoscopic Third Ventriculostomy in Patients with Shunt Malfunction

Lee

Kong

Seol

et al. 2011

J Korean Neurosurg Soc

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“…Endoscopic third ventriculostomy is established as an advantageous treatment alternative compared with ventriculoperitoneal shunting in selected patients with noncommunicating hydrocephalus. 11,12,15 The patient with noncommunicating hydrocephalus due to a posterior third ventricular or pineal region tumor is an ideal candidate for ETV. Adding only several additional minutes to the surgical procedure, ETV is easily integrated at the time of tissue biopsy.…”

Section: Advances In Neurosurgical Managementmentioning

confidence: 99%

Surgical management of primary central nervous system germ cell tumors

Souweidane

Krieger

Weiner

et al. 2010

PED

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The successful treatment of children with a primary CNS germ cell tumor can be greatly influenced by the neurosurgeon involved in the diagnostic and therapeutic care of these children. Variability in surgical philosophies no doubt exists due to the relatively infrequent incidence of these tumors, a lack of consensus regarding diagnostic and therapeutic approaches, and the advent of recent surgical innovations. Many of these issues were discussed at the Second International Symposium on Central Nervous System Germ Cell Tumors through presented abstracts and invited presentations. The neurosurgical aspects of these proceedings are summarized here in an effort to present the agreed-upon and debated issues that may confront the pediatric neurosurgeon.

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“…It was successful in eleven of 31 cases (35%). Some authors have reported a low success rate in children below two years of age (Jones et al 1990), but others have argued that it is the aetiology and not the age that is most important in determining whether or not ETV will work (Beems and Grothenius 2002). It has been reported to be successful in between 50% and 90% of populations comprising both children and adults (Beems and Grothenius 2002, Choi et al 1999, Tisell et al 2000.…”

Section: Fig 7 Newborn Children With Neural Tube Defects (Ntd) (Anenmentioning

confidence: 99%

Vision in children with hydrocephalus

Andersson¹,

Persson²,

Aring³

et al. 2006

Dev Med Child Neurol

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Aims: To analyse trends in the live-birth prevalence of infantile hydrocephalus and hydrocephalus associated with myelomeningocele (MMC) during the period [1989][1990][1991][1992][1993][1994][1995][1996][1997][1998][1999][2000][2001][2002] and to study the outcome in terms of learning disability, cerebral palsy, epilepsy and visual deficits. Another objective was to explore motor function and disability profiles in various aetiological and gestational-age subgroups and to see whether treatment complications and neuroradiological findings correlate with outcome. Material and methods: A population-based study of all 262 live-born children with infantile hydrocephalus and hydrocephalus associated with MMC born in 1989-2002 in western Sweden. Aetiological and clinical information was collected from medical records, neuroimaging and ophthalmological examinations. A subgroup of 114 children were clinically examined and interviewed. Results: The live-birth prevalence of hydrocephalus was 0.77 per 1,000 live births, 0.48 for infantile hydrocephalus and 0.29 for hydrocephalus associated with MMC. The prevalence of infantile hydrocephalus decreased from 0.55 in 1989 to 0.48 per 1,000 in 2002, while that of MMC decreased from 0.35 to 0.16 per 1,000 during the same period. The prevalence in children born extremely preterm increased dramatically, with a gestational-age-specific prevalence of 13 per 1,000 in 1989 compared with 45 per 1,000 live births in 2002. During the same period, the perinatal mortality in these children decreased from 40 to 15 per 1,000 live births. A ventriculoperitoneal shunt was the first surgical intervention in 230 children (88%), while an endoscopic ventriculostomy was performed in 31 (12%). At least one surgical revision was required in 64% of the children. Of children with infantile hydrocephalus, 63% had at least one associated impairment, compared with 33% in the MMC group, apart from the consequences of the spinal lesion. Visual and other ophthalmological impairments were identified in the majority of the children. Very preterm birth was associated with a high risk of visual impairment. No child with normal neuroimaging had any associated neurological or visual impairment, compared with eleven of twelve with impairments in children with generalised parenchymal lesions. Conclusions: A decrease in the prevalence of infantile hydrocephalus was noted during the period 1989-1998, but it did not continue in 1999-2002. The stagnation was mainly explained by the increased survival of children born extremely preterm with post-haemorrhagic hydrocephalus. The aetiology of the hydrocephalus and gestational age at birth were important for outcome. The majority of the children had some associated neuroimpairment, such as learning disability, cerebral palsy or epilepsy, and more than three-quarters had ophthalmological abnormalities. Neuroimaging was found to be useful for aetiological, treatment and outcome considerations.

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Endoscopic Third Ventriculostomy

Cited by 303 publications

References 0 publications

Endoscopic Third Ventriculostomy in Patients with Shunt Malfunction

Endoscopic Third Ventriculostomy in Patients with Shunt Malfunction

Surgical management of primary central nervous system germ cell tumors

Vision in children with hydrocephalus

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