Neuroendoscopic Third Ventriculostomy A Practical Alternative to Extracranial Shunts in Non-Communicating Hydrocephalus

Jones, Robert; Kwok, Bernard; Stening, W. A.; Vonau, Marianne

doi:10.1007/978-3-7091-6908-7_14

Cited by 60 publications

(56 citation statements)

References 12 publications

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“…The best time to perform ETV in pediatric patients is still the subject of debate. Like other authors, 22,23,39) we think that the efficacy of ETV is significantly higher in children older than 2 years of age.…”

Section: Discussionsupporting

confidence: 78%

“…14,21,22,28,36,44) Subdural hygromas or effusions, which are not genuine subdural hematomas, may occur after shunting procedures or other neurosurgical interventions, but are usually absorbed postoperatively without evolution, unless infection or bleeding complications are present, and do not require surgical intervention. Hygromas usually have a benign course even as a post-shunt phenomenon, and will not need surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

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Subdural Hygroma as a Complication of Endoscopic Neurosurgery. Two Case Reports.

Freudenstein

Wagner

Ernemann

et al. 2002

Neurol. Med. Chir.(Tokyo)

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Two cases of subdural hygroma occurred in a series of 77 neuroendoscopic procedures. An 8-year-old boy underwent neuroendoscopic cysto-cisternostomy of a left temporal arachnoid cyst. Routine postoperative magnetic resonance imaging 7 days later showed a large left-sided subdural hygroma without clinical symptoms. During the following 3 months, the subdural hygroma did not resolve spontaneously, so it was drained through a burr hole. A 3-month-old boy with aqueductal stenosis developed bilateral subdural hygromas after third ventriculostomy. Several punctures through the open anterior fontanelle relieved the hygromas but increasing head circumference required ventriculoperitoneal shunting 12 months later. Complications of neuroendoscopic procedures are increasingly reported, including various kinds of bleeding, infections, or damage of neuronal tissue. Only three previous cases of subdural hygroma or hematoma after neuroendoscopic interventions have been reported. The possible etiologies and clinical consequences of this rare complication have to be considered before selecting neuroendoscopy treatment.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Subdural Hygroma as a Complication of Endoscopic Neurosurgery. Two Case Reports.

Freudenstein

Wagner

Ernemann

et al. 2002

Neurol. Med. Chir.(Tokyo)

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“…In Uganda, for example, it is used together with plexus cauterisation to eliminate the risk of shunt complications which are difficult to handle in the developing countries (Warf 2005). Improvements in technology and neuroradiology have made ETV safer, with reduced morbidity and mortality rates (Drake 1993, Jones et al 1994). …”

Section: Treatmentmentioning

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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“…The most frequent intraoperative complications are haemostatic problems and infection. However, injury of the basilar artery complex is the most feared intraoperative complication and can cause massive intraventricular and subarchnoid hemorrhage, hemiparesis and midbrain damage (Jones & Kwok, 1994). Meningeal irritation, headache and high fever from an inflammatory response to irrigating fluid can occur (Oka et al, 1996).…”

Section: Complicationsmentioning

confidence: 99%

Anaesthetic Management of Patients Undergoing Intraventricular Neuro-Endoscopic Procedures

Kalmar¹,

Dewaele²

2012

Explicative Cases of Controversial Issues in Neurosurgery

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Neuroendoscopic Third Ventriculostomy A Practical Alternative to Extracranial Shunts in Non-Communicating Hydrocephalus

Cited by 60 publications

References 12 publications

Subdural Hygroma as a Complication of Endoscopic Neurosurgery. Two Case Reports.

Subdural Hygroma as a Complication of Endoscopic Neurosurgery. Two Case Reports.

Vision in children with hydrocephalus

Anaesthetic Management of Patients Undergoing Intraventricular Neuro-Endoscopic Procedures

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