Endoscopic Third Ventriculostomy for Obstructive Hydrocephalus and Ventriculocystostomy for Intraventricular Arachnoid Cysts.

Fatih Serhat Erol,Fatih Demir,Sait Ozturk,Omer Batu Hergunsel,Bekir Akgun

doi:10.14712/18059694.2021.5

Abstract

To evaluate and discuss the outcomes of a combination of ventriculocystostomy (VC) and endoscopic third ventriculostomy (ETV) for obstructive hydrocephalus (HCP) due to ventricular/cisternal arachnoid cysts, and only ETV for obstructive HCP due to different etiologies. We retrospectively reviewed all 40 symptomatic patients (aged 4 months - 61 years) of obstructive HCP treated by ETV or VC+ETV during October 2014 - April 2019. VC+ETV was performed in 7 patients with intraventricular/cisternal arachnoid cyst and obstructive HCP. Only ETV was performed in 33 patients with obstructive HCP due to other etiologies. Successful ETV or VC+ETV surgery was performed in 35 patients. The procedure failed in 5 patients aged 90 percentile at the time of surgery. Another 5 patients aged 90 percentile).

Highlights

Hydrocephalus (HCP) is one of the most common conditions encountered in neurosurgical practice
It is a spectrum of conditions involving an imbalance of cerebrospinal fluid (CSF) production and absorption, with resultant enlarged ventricles that are usually associated with the clinical sequelae of increased intracranial pressure (ICP) [1, 2]
We retrospectively reviewed all cases of obstructive HCP treated with endoscopic third ventriculostomy (ETV) or VC+ETV between October 2014 and April 2019 at our hospital

Summary

Introduction

Hydrocephalus (HCP) is one of the most common conditions encountered in neurosurgical practice. ETV has gained popularity in the recent years, with evident advantages over the ventriculoperitoneal shunt (VPS) as patients remain device-free [1, 2, 5] This technique provides direct communication between the third ventricle and interpeduncular and prepontine subarachnoid spaces so as to re-establish the normal CSF flow by perforating the floor of the third ventricle [2, 5, 7]. It is the treatment of choice for obstructive HCP (stenosis of the aqueduct of Sylvius, Dandy–Walker malformation and Chiari malformations types I and II) [8]. The highest success rates have been reported in patients with obstructive HCP secondary to aqueductal stenosis [10]

Methods

Results

Discussion

Conclusion