Treatment of multi-loculated hydrocephalus using endoscopic cyst fenestration and endoscopic guided VP shunt insertion

Endoscopic treatment of complex multiloculated hydrocephalus in children, steps that may help to decrease revision rate

“…The low rate and severity of complications observed in our patients are in line with the previous studies which concluded that complications following endoscopic approach were usually minor and were mostly treated conservatively. [ 8 , 9 , 12 , 13 , 17 , 25 , 29 ]…”

“…Piyachon et al . [ 25 ] mentioned that complications were encountered in two out of 20 patients in their series following endoscopic fenestration of cysts. The two patients suffered transient subdural hematoma which was resolved by conservative management.…”

“…The rate of success of single shunt in our patients (64% in Group A and 80% in Group B) is nearly similar to rates reported in the literature following standard endoscopic technique which ranged from 61.8% to 100%. [ 7 , 9 , 12 , 22 , 23 , 25 , 33 ]…”

“…Spennato et al .,[ 29 ] El-Ghandour,[ 8 ] Akbari et al .,[ 1 ] and Piyachon et al . [ 25 ] reported redo rates for endoscopic surgery of 30.4%, 33%, 38.5%, and 35%, respectively. Zuccaro and Ramos[ 33 ] found that 53% of their patients required another operative intervention.…”

“…This is conforming with Piyachon et al . [ 25 ] who found that a higher rate of redo endoscopic fenestration was detected among patients with prior shunt insertion, but with no significant difference. Some studies suggested that conditions related to neurosurgical interventions and shunt may play important role in causing septation and loculation, such as shunt-related infection,[ 16 , 21 ] direct ependymal trauma during catheter insertion,[ 10 ] and intracranial surgery.…”