BACKGROUND: Shunt devices to treat hydrocephalus are associated with a malfunction of 81 % at 12 years and 10 % of infection. The objective was to assess safeness and efficacy of endoscopic third ventriculostomy (ETV) for the treatment of chronic communicating hydrocephalus. METHODS: Eight patients with chronic communicating hydrocephalus were included in a period between September, 2012 and April, 2013. X ray computed tomography scans were performed when patients were admitted, after the surgery, and at 30, 180 and 365 days. The follow-up was of 251 days (the biggest was of 459 days). The variables included were: age, sex, etiology, time of evolution, and the total number of shunt malfunctions. Conventional technique with a 30° rigid endoscope was performed, malfunctional shunt was removed, and a tied shunt device was placed. RESULTS: Four males and four females, with a mean age of 42 years (27-63 years); neurocysticercosis was identified in five patients (62.5 %); the evolution rate was of 18 years (15-30 years); the hospital stay rate was of 6.5 days (3-22 days); the mean of previous shunt malfunctions was 4 (1-6). COMPLICATIONS: neuroinfection in one patient, malfunction in three patients. None of them died. CONCLUSIONS: ETV is a safety procedure for treating chronic communicating hydrocephalus; it has a success rate higher than 60 %. Neurocysticercosis showed better results when previous shunt malfunctions were lower than three.
BACKGROUND: Shunt devices to treat hydrocephalus are associated with a malfunction of 81 % at 12 years and 10 % of infection. The objective was to assess safeness and efficacy of endoscopic third ventriculostomy (ETV) for the treatment of chronic communicating hydrocephalus. METHODS: Eight patients with chronic communicating hydrocephalus were included in a period between September, 2012 and April, 2013. X ray computed tomography scans were performed when patients were admitted, after the surgery, and at 30, 180 and 365 days. The follow-up was of 251 days (the biggest was of 459 days). The variables included were: age, sex, etiology, time of evolution, and the total number of shunt malfunctions. Conventional technique with a 30° rigid endoscope was performed, malfunctional shunt was removed, and a tied shunt device was placed. RESULTS: Four males and four females, with a mean age of 42 years (27-63 years); neurocysticercosis was identified in five patients (62.5 %); the evolution rate was of 18 years (15-30 years); the hospital stay rate was of 6.5 days (3-22 days); the mean of previous shunt malfunctions was 4 (1-6). COMPLICATIONS: neuroinfection in one patient, malfunction in three patients. None of them died. CONCLUSIONS: ETV is a safety procedure for treating chronic communicating hydrocephalus; it has a success rate higher than 60 %. Neurocysticercosis showed better results when previous shunt malfunctions were lower than three.
Authors: Luis J Saavedra; Carlos M Vásquez; Hector H García; Luis A Antonio; Yelimer Caucha; Jesús Félix; Jorge E Medina; William W Lines Journal: J Neurosurg Case Lessons Date: 2021-07-19