scholarly journals Endoscopic Third Ventriculostomy: Our Experience of Consecutive 50 Cases at a Tertiary Care Center

2022 ◽  
Author(s):  
Ramesh Chandra Venkata Vemula ◽  
BCM Prasad ◽  
Kunal Kumar
Keyword(s):  
Success Rate ◽  
Endoscopic Third Ventriculostomy ◽  
Perioperative Complications ◽  
Obstructive Hydrocephalus ◽  
Care Center ◽  
External Ventricular Drain ◽  
Tertiary Care ◽  
Third Ventriculostomy ◽  
Magnetic Resonance Imaging Scan ◽  
Case Selection

Abstract Objective The aim of this study was to do a retrospective analysis of the various neurosurgical pathologies where endoscopic third ventriculostomy (ETV) was used and to evaluate the outcome and prognosis. Methods The retrospective data collection was done for the patients who underwent ETV with or without other adjunct procedures; the results were prepared for clinical presentation, diagnosis, surgical approach, and surgical goal; and success rate and prognosis were analyzed and compared with other studies. Results A total of 50 patients were included in the study, with overall success rate of ETV as 88%; aqueductal stenosis was the most common indication where ETV was used; headache and vomiting were the most common presenting complaints followed by ataxia and visual blurring; and ETV provided flexibility in its use with biopsy, abscess drainage, temporary external ventricular drain placement, etc. Conclusion ETV being superior to ventriculo-peritoneal shunt for obstructive hydrocephalus provides flexibility in its use and possibly is a useful adjunct to prevent postoperative hydrocephalus after endoscopic intraventricular surgery; proper case selection in accordance to ETV success score yields a better success rate. In experienced hands with proper precautions, perioperative complications can be kept at minimum. Wherever possible, in cases of obstructive hydrocephalus, especially in patients >1 year of age, ETV should be the treatment of choice. We recommend a proper case selection, including preoperative detailed reading of sagittal magnetic resonance imaging scan, to improve the success rate with less complication.

scholarly journals Endoscopic Third Ventriculostomy in Cases of Hydrocephalus: An Institutional Experience

2019 ◽  
Vol 08 (03) ◽  
pp. 151-154
Author(s):  
Prarthana Saxena ◽  
Sharad Pandey ◽  
Pankaj Kumar ◽  
Kaviraj Kausik ◽  
Shiv Lal Soni
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Clinical Symptoms ◽  
Obstructive Hydrocephalus ◽  
Care Center ◽  
Tertiary Care ◽  
Aqueductal Stenosis ◽  
Third Ventriculostomy ◽  
Tubercular Meningitis ◽  
Effective Treatment Modality ◽  
Institutional Experience

Abstract Background With the recent advances in optical and mechanical instrumentation, endoscopic third ventriculostomy (ETV) has emerged as the procedure of choice for the treatment of hydrocephalus in selected patients. Objective: To study the role of ETV in therapeutic management of hydrocephalus in a tertiary care center. Materials and Methods The present study was conducted in the Department of Neurosurgery at Dr. Ram Manohar Lohia Hospital. Endoscopic third ventriculostomy was performed as a therapeutic procedure in patients diagnosed with hydrocephalus requiring surgical intervention and admitted from June 2017 to July 2018. ETV success was defined by resolution or improvement in clinical symptoms and ETV failure was considered in patients whose symptoms either deteriorated or did not improve from the baseline and required ventriculoperitoneal shunt. Results A total of 85 patients were included in this study who underwent the therapeutic ETV. In the present study, the overall ETV success rate was 75.2% (64/85). 86.7% cases of aqueductal stenosis, 74.4% cases of post meningitis (including tubercular meningitis) hydrocephalus, and 71% of posterior fossa tumors showed resolution or improvement in clinical symptoms. Conclusion ETV is an effective treatment modality for obstructive hydrocephalus and with better results in post meningitis hydrocephalus and post tubercular meningitis hydrocephalus. However, more extensive studies dedicated to ETV with a larger sample size are required to further study its efficacy in various etiologies.

scholarly journals Endoscopic Third Ventriculostomy in Previously Shunted Children

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Eva Brichtova ◽  
Martin Chlachula ◽  
Tomas Hrbac ◽  
Radim Lipina
Keyword(s):  
Success Rate ◽  
Fourth Ventricle ◽  
Pediatric Patients ◽  
Endoscopic Third Ventriculostomy ◽  
Obstructive Hydrocephalus ◽  
Surgical Revision ◽  
Clinical State ◽  
Third Ventriculostomy ◽  
Safe Procedure ◽  
Shunt Implantation

Endoscopic third ventriculostomy (ETV) is a routine and safe procedure for therapy of obstructive hydrocephalus. The aim of our study is to evaluate ETV success rate in therapy of obstructive hydrocephalus in pediatric patients formerly treated by ventriculoperitoneal (V-P) shunt implantation. From 2001 till 2011, ETV was performed in 42 patients with former V-P drainage implantation. In all patients, the obstruction in aqueduct or outflow parts of the fourth ventricle was proved by MRI. During the surgery, V-P shunt was clipped and ETV was performed. In case of favourable clinical state and MRI functional stoma, the V-P shunt has been removed 3 months after ETV. These patients with V-P shunt possible removing were evaluated as successful. In our group of 42 patients we were successful in 29 patients (69%). There were two serious complications (4.7%)—one patient died 2.5 years and one patient died 1 year after surgery in consequence of delayed ETV failure. ETV is the method of choice in obstructive hydrocephalus even in patients with former V-P shunt implantation. In case of acute or scheduled V-P shunt surgical revision, MRI is feasible, and if ventricular system obstruction is diagnosed, the hydrocephalus may be solved endoscopically.

ENDOSCOPIC THIRD VENTRICULOSTOMY (ETV) IS A BETTER ALTERNATIVE FOR VP SHUNT FAILURE IN NON-COMMUNICATING HYDROCEPHALUS

2021 ◽  
pp. 65-67
Author(s):  
Ramesh Tanger ◽  
Dinesh Kumar Barolia ◽  
Arka Chatterjee ◽  
Punit Singh Parihar ◽  
Arun Gupta
Keyword(s):  
Success Rate ◽  
Endoscopic Third Ventriculostomy ◽  
Obstructive Hydrocephalus ◽  
Shunt Revision ◽  
Third Ventriculostomy ◽  
Communicating Hydrocephalus ◽  
Shunt Failure ◽  
Shunt Insertion ◽  
Vp Shunt

CONTEXT: VP Shunt is most commonly used procedure for hydrocephalus but shunt failure is also the common complication in many patients. Endoscopic third ventriculostomy (ETV) is an accepted procedure for the treatment of obstructive hydrocephalus. The aim of our study is to evaluate the success rate AIM AND OBJECTIVE - of ETV in patients of obstructive hydrocephalus formerly treated by ventriculo-peritoneal (VP shunt) shunt. The failure VP shunt was removed before ETV. MATERIALS AND METHOD: This study was conducted between June 2015 and December 2019 in single unit of our department. Twenty one (n=21) patients were enrolled for this study. All patients were admitted with failure of VP shunt. They were known case of non-communicating hydrocephalus previously operated for VP shunt. Six patients were excluded for ETV because CT/MRI show grossly distorted anatomy of ventricles. Endoscopic third ventriculostomy was attempted in 15 patients, but ventriculostomy was done successfully in 10 patients, rests were treated with revision of VP shunt. All patients in this study were radiologically diagnosed RESULTS: case of hydrocephalus due to aqueduct stenosis. They were experienced VP shunt insertion but there were failure of shunt due to any reason. ETV procedures were done successfully in 10 patients. Out of 10 patients one patient needed shunt insertion due ineffective ETV. Shunt revision was done in 11 patients. There was no serious complication during and after ETV procedures. The follow-up period of patients with successful ETV was 6–60 months. This follow-up was uneventful and peaceful for their parents. ETV can be considered as an alternative treatment for the patients w CONCLUSION: ith VP shunt failure with an acceptable success rate of 80%, although long-term follow-up is needed for these patients.

scholarly journals Efficacy and Safety of Endoscopic Third Ventriculostomy in Obstructive Hydrocephalus

2017 ◽  
Vol 14 (2) ◽  
pp. 21-24
Author(s):  
Sachidanad Gautam ◽  
Sumit Kamble
Keyword(s):  
Success Rate ◽  
Endoscopic Third Ventriculostomy ◽  
Obstructive Hydrocephalus ◽  
Case Series ◽  
Cost Effective ◽  
Third Ventriculostomy ◽  
Safe Procedure ◽  
Success Rates ◽  
Replacement Procedure ◽  
Ventricular Hemorrhage

Endoscopic third ventriculostomy is the procedure of choice to treat obstructive hydrocephalus now a days. Published case series of endoscopic third ventriculostomy (ETV) for childhood hydrocephalus have reported widely varying success rates. The purpose of this study is to determine the success rate and complications of ETV for treating obstructive hydrocephalus.Patients with obstructive hydrocephalus and already shunted patients for obstructive hydrocephalus presented with blocked shunt were included in the study. The exclusion criteria consisted ofrecurrent tumor or intra ventricular hemorrhage. Endoscopic third ventriculostomy was performed. Patients were followed up for one year and Clinical and Radiological improvement, complications and mortality was noted. This study was conducted in Neurosurgery Department, Govt. Medical College, Kota between 2015-2016.There were 56 patients including 36 males and 20females. Success rate in the form of clinical and/ or radiological improvement was seen in 88.8% 0f patients. Complications were seen in 6 patients including ETV failure and ventricular hemorrhage. There was no mortality during follow up period of 1 year.ETV is cost effective and safe procedure in patients with obstructive hydrocephalus with good outcome. It may be used as replacement procedure of ventriculo-peritoneal shunt as initial line of management in selected patients based on ETV score. Nepal Journal of Neuroscience, Vol. 14, No. 2,  2017 Page: 21-24

scholarly journals Endoscopic third ventriculostomy in the treatment of hydrocephalus: A 20-year retrospective analysis of 209 consecutive cases

2021 ◽  
Vol 12 ◽  
pp. 383
Author(s):  
Igor Vilela Faquini ◽  
Ricardo Brandão Fonseca ◽  
Alyne Oliveira Correia ◽  
Auricelio Batista Cezar Junior ◽  
Eduardo Vieira De Carvalho Junior ◽  
...  
Keyword(s):  
Success Rate ◽  
Endoscopic Third Ventriculostomy ◽  
Clinical Success ◽  
Obstructive Hydrocephalus ◽  
Aqueductal Stenosis ◽  
Third Ventriculostomy ◽  
Csf Fistula ◽  
Group A ◽  
Independent Risk Factors ◽  
Group B

Background: Endoscopic third ventriculostomy (ETV) has been shown to be a sufficient alternative to shunts in surgical treatment of obstructive hydrocephalus. Long-term failure, age limitations, and outcome by cause are some of the issues debated in literature. The objective of this article is to analyze the clinical success and failure of ETV and its main complications. Methods: A total of 209 patients with hydrocephalus were submitted to ETV, including a mixed population of children and adults (from 0 to 59 years). Patients were divided into five groups: A – tumors, B – aqueductal stenosis, C – myelomeningocele, D – infection and hemorrhage, and E – arachnoid cyst. Variables were analyzed: age, ETV success rate, cerebrospinal fluid (CSF) fistula, mortality, and complications. Results: The two main causes of hydrocephalus were tumors (44.9%) and aqueductal stenosis (25.3%). The overall success rate was of 82.8%, and patients in Group E had the highest rate 90.9%. Group A had a success rate of 89.3%, and Group B had a rate of 88.6%. The ETV success rate was significantly higher in patients older than 1 year (P < 0.001); the former also had a lower risk of CSF fistula (P < 0.0001). The overall mortality rate was 2.8%. Conclusion: Better results were observed in the groups of patients with tumors, aqueductal stenosis, and arachnoid cysts, while those whose primary causes of hydrocephalus were myelomeningocele, infections, or bleeding had higher rates of failure after the procedure. This study demonstrated that age under 1 year and hydrocephalus caused by myelomeningocele, bleeding, and infection were considered independent risk factors of poor prognosis in ETV.

scholarly journals Endoscopic third ventriculostomy for obstructive hydrocephalus

2020 ◽  
pp. 269-274
Author(s):  
Hassan Z.A. Dixon ◽  
Yasir M. Hamandi ◽  
Ammar M.A. Mahmmoud ◽  
Samer S. Hoz ◽  
Zahraa F. Al-Sharshahi
Keyword(s):  
Success Rate ◽  
Endoscopic Third Ventriculostomy ◽  
Obstructive Hydrocephalus ◽  
Csf Leak ◽  
Third Ventriculostomy ◽  
Success Rates ◽  
Shunt Insertion ◽  
Female Ratio ◽  
Common Cause ◽  
Select Group

Introduction: Obstructive hydrocephalus has long been managed by valve-regulated shunts. These shunts are associated with a myriad of short and long-term complications. This has fueled interest in Endoscopic Third Ventriculostomy (ETV) which provides a more physiological pathway for cerebrospinal fluid (CSF) diversion while avoiding many shunt-related complications. Aim: The objective of this study is to analyze the outcomes of ETV at our institution, focusing on the indications, success rates, and short-term complications. Methods: Between July 2010 and September 2015, 47 patients with obstructive hydrocephalus underwent ETV at the Neurosurgery Teaching Hospital in Baghdad/ Iraq. We retrospectively analyzed the data of these patients using hospital health records. Simple statistics were performed using  SPSS Version 20. A standardized surgical technique was employed in all cases. Results: The mean age was 4.4 years (range 40 days - 38 years). The male: female ratio was 1.23:1 (55% males and 45% females). The most common cause of obstructive hydrocephalus in patients undergoing ETV was aqueductal stenosis (62%; N=29). The second most common cause was posterior fossa tumours (23%; N=11). The overall success rate for ETV was 68%. The net post-operative complication rate was 13% (N=6). CSF leak and seizures were the only two charted post-operative complications at the rates of 9%(N=4) and 4% (N=2), accordingly. No deaths were recorded. Conclusion: ETV is a viable alternative to shunt insertion in a select group of patients with obstructive hydrocephalus, with acceptable success rate and safety profile.

scholarly journals Endoscopic third ventriculostomy in children: problems and surgical outcome: analysis of 34 cases

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Md Moshiur Rahman ◽  
S. I. M. Khairun Nabi Khan ◽  
Robert Ahmed Khan ◽  
Rokibul Islam ◽  
Mainul Haque Sarker
Keyword(s):  
Success Rate ◽  
Endoscopic Third Ventriculostomy ◽  
Obstructive Hydrocephalus ◽  
Predisposing Factors ◽  
Outcome Analysis ◽  
Third Ventriculostomy ◽  
Communicating Hydrocephalus ◽  
Stoma Closure ◽  
Arachnoid Membrane ◽  
The Mean

Abstract Background Endoscopic third ventriculostomy (ETV) has been established as a viable treatment option for obstructive hydrocephalus of children over 6 weeks of age. ETV in pediatric groups may be unsuccessful due to the failure of absorption of cerebrospinal fluid (CSF) or reclosure of ventriculostomy stoma or due to infection. The exact cause is still debatable. Some issues like failure to eliminate the second membrane during the procedure or formation of the new arachnoid membrane at the stoma are still not clear. This study aims to assess the surgical failure of ETV and its predisposing factors. Methods Thirty-four pediatric patients with hydrocephalus were analyzed retrospectively. The patients’ age limit was between 2.5 months and 14 years. This is a retrospective study of 34 patients in a single private hospital between June 2012 and January 2018. Patients having hydrocephalus in pediatric groups more than 6 weeks of age were included in the study. Results The mean age of all patients was 51.25 ± 53.90 months and the mean follow-up period was 50.47 ± 20.84 months. Of 34 surgeries, the success rate was 79% and the failure rate was 21%. Within 2 years, the success rate was 68.42% and above 2 years’ success rate was 93.33%. In this series, 7 cases of ETV were re-explored and found ventriculostomy stoma closure in 3 cases, the presence of the second membrane in re-exploration 2 cases, and presence of inflammatory arachnoid membrane in re-exploration 2 cases. The use of dexamethasone around the stoma in inflammatory stoma was useful, having no recurrence. In one patient of the second membrane probably due to absorption failure in communicating hydrocephalus re-exploration was failed and was managed successfully with VP shunt. Conclusions Predisposing factors causing ETV failure are ventriculostomy stoma closure by new arachnoid granulation tissues, remnants of the second membrane inside the stoma, CSF absorption failure, infection/high protein in CSF and inappropriate patient selection.

MULTIFOCAL COMPLEX GLIONEURONAL TUMOR IN AN ELDERLY MAN

Neurosurgery ◽  
2009 ◽  
Vol 64 (6) ◽  
pp. E1193-E1195 ◽  
Author(s):  
Jian-Qiang Lu ◽  
Bernd W. Scheithauer ◽  
Pranshu Sharma ◽  
James N. Scott ◽  
Ian F. Parney ◽  
...  
Keyword(s):  
Obstructive Hydrocephalus ◽  
External Ventricular Drain ◽  
Third Ventricle ◽  
Glioneuronal Tumor ◽  
Third Ventriculostomy ◽  
Magnetic Resonance Imaging Scan ◽  
Dysembryoplastic Neuroepithelial Tumor ◽  
Histological Features ◽  
The Third ◽  
Glioneuronal Tumors

Abstract OBJECTIVE The clinicopathological spectra of a dysembryoplastic neuroepithelial tumor (DNT) and a rosette-forming glioneuronal tumor (RGNT) are expanding. We report here the autopsy findings of a case of complex glioneuronal tumor with combined histological features of both a DNT and an RGNT. CLINICAL PRESENTATION A 79-year-old man presented with a 1-month history of confusion and gait difficulties. A magnetic resonance imaging scan revealed obstructive hydrocephalus attributed to a mass in the posterior third ventricle. INTERVENTION A third ventriculostomy was performed. Postoperatively, the mass remained unchanged in size for more than 14 months. Thirty-eight months after his initial manifestations, he experienced minor head trauma and was then hospitalized. Despite placement of an external ventricular drain and other supportive treatment, he deteriorated and died. A full autopsy was performed, with emphasis on the brain. The mass lesion and a few independent microfoci situated primarily around the third ventricle showed histological features of pilocytic astrocytoma with recurrent hemorrhage. Far more numerous were microfoci with histological features of a DNT, including floating neurons, as well as typical RGNT-associated, synaptophysin-positive rosettes and perivascular pseudorosettes. CONCLUSION The advanced age of the patient, the coexisting histological features of the DNT and RGNT, and the distinctive anatomic distribution of the lesions, being centered on the third ventricle, may lend insight into the histogenetic relationship of a DNT, an RGNT, and mixed glioneuronal tumors.

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