D Santamarta1, J Martin-Vallejo. 1. Department of Neurosurgery, University Hospital of Salamanca, Salamanca, Spain. dsantamarta@wanadoo.es
Abstract
OBJECTIVE: To establish a more accurate indication for endoscopic third ventriculostomy (ETV) in patients with noncommunicating hydrocephalus through the analysis of the evolution of postoperative mean intracranial pressure (ICPM). METHOD: Intracranial pressure (ICP) was recorded overnight during 8-hour periods with an intraventricular probe. A personal computer connected to the ICP monitor minutely recorded the values of ICP. Twenty-four patients were monitored from day 1 to day 3 after ETV. The evolution of ICPM was analysed with an ANOVA test for repeated measures. The relevance of different factors (age, etiology, size of the lesion leading to hydrocephalus, clinical course and outcome) on the evolution of ICPM was explored with a two-factor ANOVA. RESULTS: ICPM progressively decreased from day 1 to day 3 after ETV (p = 0.03). ICPM on the first postoperative day was 15.81 +/- 2.04 mm Hg (mean +/- standard error) and 13.43 +/- 1.44 mm Hg on the third postoperative day. Different patterns in the evolution of ICPM have been detected according to the age of the patient and the clinical course of hydrocephalus. CONCLUSION: ICPM progressively decreases after ETV. This pattern is not constant. It has been clearly detected in children and in acute forms of hydrocephalus.
OBJECTIVE: To establish a more accurate indication for endoscopic third ventriculostomy (ETV) in patients with noncommunicating hydrocephalus through the analysis of the evolution of postoperative mean intracranial pressure (ICPM). METHOD: Intracranial pressure (ICP) was recorded overnight during 8-hour periods with an intraventricular probe. A personal computer connected to the ICP monitor minutely recorded the values of ICP. Twenty-four patients were monitored from day 1 to day 3 after ETV. The evolution of ICPM was analysed with an ANOVA test for repeated measures. The relevance of different factors (age, etiology, size of the lesion leading to hydrocephalus, clinical course and outcome) on the evolution of ICPM was explored with a two-factor ANOVA. RESULTS: ICPM progressively decreased from day 1 to day 3 after ETV (p = 0.03). ICPM on the first postoperative day was 15.81 +/- 2.04 mm Hg (mean +/- standard error) and 13.43 +/- 1.44 mm Hg on the third postoperative day. Different patterns in the evolution of ICPM have been detected according to the age of the patient and the clinical course of hydrocephalus. CONCLUSION: ICPM progressively decreases after ETV. This pattern is not constant. It has been clearly detected in children and in acute forms of hydrocephalus.