Laura Baeza-Antón1, María Isabel Martínez-León2, Bienvenido Ros-López3, Miguel Ángel Arráez-Sánchez3. 1. Department of Neurosurgery, HGU Doctor Negrín, Las Palmas de Gran Canaria, Spain. laubaeza1221@gmail.com. 2. Pediatric Radiology Section, Department of Radiodiagnosis, HRU Carlos Haya, Las Palmas de Gran Canaria, Spain. 3. Pediatric Neurosurgery Section, Department of Neurosurgery, HRU Carlos Haya, Málaga, Spain.
Abstract
OBJECTIVE: The aim of this study was to analyze the role of endoscopic third ventriculostomy (ETV) in the treatment of pediatric chronic communicating congenital hydrocephalus (CCCH). MATERIAL AND METHODS: This retrospective study comprised a series of 11 children with CCCH treated with ETV. Data were recorded on gender, history, presenting symptoms, age at surgery, complications during surgery, clinical evolution, ETV survival, and follow-up period. Radiological variables including ventricular and cephalic diameters were also recorded to determine a series of ventricular indexes in magnetic resonance imaging (MRI) before and after the ETV procedure. The procedure was considered to be successful when there was clinical stability or improvement accompanied by a reduction in the radiological indexes in the postoperative control images, such that there was no need to place an extrathecal cerebrospinal fluid shunt. RESULTS: Over a mean follow-up period of 35.8 months (range: 6-108 months) from the ETV procedure, three patients required shunt placement; one of these was due to early failure in an 8-month old girl, the only patient younger than 12 months in our series. The radiological indexes were reduced in all patients except for one of the cases of ETV failure. The mean ETV survival among the successful cases was 32.1 months (range: 6-108 months), whilst that of the failed cases was 16 months (range: 6-108 months). CONCLUSION: Although studies with larger sample sizes are needed, ETV appears to be a promising option for the treatment of this type of patient with CCCH.
OBJECTIVE: The aim of this study was to analyze the role of endoscopic third ventriculostomy (ETV) in the treatment of pediatric chronic communicating congenital hydrocephalus (CCCH). MATERIAL AND METHODS: This retrospective study comprised a series of 11 children with CCCH treated with ETV. Data were recorded on gender, history, presenting symptoms, age at surgery, complications during surgery, clinical evolution, ETV survival, and follow-up period. Radiological variables including ventricular and cephalic diameters were also recorded to determine a series of ventricular indexes in magnetic resonance imaging (MRI) before and after the ETV procedure. The procedure was considered to be successful when there was clinical stability or improvement accompanied by a reduction in the radiological indexes in the postoperative control images, such that there was no need to place an extrathecal cerebrospinal fluid shunt. RESULTS: Over a mean follow-up period of 35.8 months (range: 6-108 months) from the ETV procedure, three patients required shunt placement; one of these was due to early failure in an 8-month old girl, the only patient younger than 12 months in our series. The radiological indexes were reduced in all patients except for one of the cases of ETV failure. The mean ETV survival among the successful cases was 32.1 months (range: 6-108 months), whilst that of the failed cases was 16 months (range: 6-108 months). CONCLUSION: Although studies with larger sample sizes are needed, ETV appears to be a promising option for the treatment of this type of patient with CCCH.
Authors: Abhaya V Kulkarni; Jay Riva-Cambrin; Richard Holubkov; Samuel R Browd; D Douglas Cochrane; James M Drake; David D Limbrick; Curtis J Rozzelle; Tamara D Simon; Mandeep S Tamber; John C Wellons; William E Whitehead; John R W Kestle Journal: J Neurosurg Pediatr Date: 2016-06-03 Impact factor: 2.375