Abstract
Objective
The purpose of this study is to assess the role of endoscopic third ventriculostomy (ETV) in the treatment of hydrocephalus
in children under 1 year of age. The authors analyzed data of ETV in their institution.
in children under 1 year of age. The authors analyzed data of ETV in their institution.
Methods
Between January 1995 and December 2008, 52 ETV procedures were performed for the treatment of hydrocephalus in 49 infants
(32 male and 17 female). Their age ranged from 6 days to just under 12 months (mean age 6.2 months). The cause of hydrocephalus
was occlusive in 43 patients (aqueduct stenosis in 31, Chiari II malformation in eight, Dandy–Walker cyst in two, quadrigeminal
lipoma in one, and cerebellopontine angle arachnoid cyst in one patient). Communicating hydrocephalus was caused by intraventricular
hemorrhage, meningitis, and/or ventriculitis in six patients.
(32 male and 17 female). Their age ranged from 6 days to just under 12 months (mean age 6.2 months). The cause of hydrocephalus
was occlusive in 43 patients (aqueduct stenosis in 31, Chiari II malformation in eight, Dandy–Walker cyst in two, quadrigeminal
lipoma in one, and cerebellopontine angle arachnoid cyst in one patient). Communicating hydrocephalus was caused by intraventricular
hemorrhage, meningitis, and/or ventriculitis in six patients.
Results
The overall success rate was 69.4% with mean follow-up period of 68.2 months. Patients with aqueduct stenosis had a higher
success rate of ETV which was 77.4%. Seven infants were born preterm, six of them required a permanent ventriculoperitoneal
shunts (VPS; P?=?0.003). Malfunctioned VPS was removed in two patients following ETV. There was one death from intracranial hemorrhage, two cerebrospinal
fluid leaks, and one meningitis.
success rate of ETV which was 77.4%. Seven infants were born preterm, six of them required a permanent ventriculoperitoneal
shunts (VPS; P?=?0.003). Malfunctioned VPS was removed in two patients following ETV. There was one death from intracranial hemorrhage, two cerebrospinal
fluid leaks, and one meningitis.
Conclusion
Endoscopic third ventriculostomy can be considered a possible treatment procedure alternative to VPS for the treatment of
occlusive hydrocephalus in infants. ETV was effective in full-term infants while the results in low birth weight, preterm
infants were poor. Success of ETV is not only age dependent but also etiology dependant. Infants with occlusive hydrocephalus
treated with VPS, who present with shunt failure, could be treated by ETV and removal of the shunt device.
occlusive hydrocephalus in infants. ETV was effective in full-term infants while the results in low birth weight, preterm
infants were poor. Success of ETV is not only age dependent but also etiology dependant. Infants with occlusive hydrocephalus
treated with VPS, who present with shunt failure, could be treated by ETV and removal of the shunt device.
- Content Type Journal Article
- DOI 10.1007/s00381-010-1254-3
- Authors
- Essam A. Elgamal, Neurosurgery Division, College of Medicine and King Khalid University Hospital, King Saud University, P O Box 7805, Riyadh, 11472 Saudi Arabia
- Abdel-Azim El-Dawlatly, Anesthesia Department, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
- Waleed R. Murshid, Neurosurgery Division, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
- Sherif M. F. El-Watidy, Neurosurgery Division, College of Medicine and King Khalid University Hospital, King Saud University, P O Box 7805, Riyadh, 11472 Saudi Arabia
- Zain Al-Abedin B. Jamjoom, Neurosurgery Division, College of Medicine and King Khalid University Hospital, King Saud University, P O Box 7805, Riyadh, 11472 Saudi Arabia
- Journal Child’s Nervous System
- Online ISSN 1433-0350
- Print ISSN 0256-7040
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