Abstract
In recent years, neuroendoscopic treatment of hydrocephalus and various ventricular pathologies has become increasingly popular. It is considered by many as the first-choice treatment for the majority of these cases. However, neurocognitive complications following ventricular neuroendoscopic procedures may occur leading mostly to amnesia, which might have a grave effect on the patient's quality of life. Studies assessing neurocognitive complications after ventricular neuroendoscopic procedures are sparse. Therefore, we conducted a systematic review assessing the available literature of neurocognitive complications and outcome after ventricular neuroendoscopy. Of 1216 articles screened, 46 were included in this systematic review. Transient and permanent neurocognitive complications in 2804 ventricular neuroendoscopic procedures occurred in 2.0% (n = 55) and 1.04% (n = 28) of the patients, respectively. Most complications described are memory impairment, followed by psychiatric symptoms (psychosyndrome), cognitive impairment not further specified, declined executive function, and confusion. However, only in 20% of the series describing neurocognitive complications or outcome (n = 40) was neurocognition assessed by a trained neuropsychologist in a systematic manner. While in most of these series only a part of the included patients underwent neuropsychological testing, neurocognitive assessment was seldom done pre- and postoperatively, long-term follow up was rare, and patient's cohorts were small. A paucity of studies analyzing neurocognitive complications and outcome, through systematic neuropsychological testing, and the correlation with intraoperative lesions of neuronal structures (e.g., fornix) exists in the literature. Therefore, the neurocognitive and emotional morbidity after ventricular neuroendoscopic procedures might be underestimated and warrants further research.
Highlights
Ventricular neuroendoscopy, for the treatment of occlusive, and nonocclusive, hydrocephalus, colloid cysts (CC), intraventricular cysts, fourth ventricle outlet obstruction (FVOO), and intraventricular tumors has become increasingly popular over the last two decades [1,2,3,4]
We provide a systematic review summarizing the rate of cognitive complications after ventricular neuroendoscopic procedures
Most studies analyzing complications after ventricular neuroendoscopy do not report on neurocognitive complications
Summary
Ventricular neuroendoscopy, for the treatment of occlusive, and nonocclusive, hydrocephalus, colloid cysts (CC), intraventricular cysts, fourth ventricle outlet obstruction (FVOO), and intraventricular tumors has become increasingly popular over the last two decades [1,2,3,4]. Various ventricular endoscopic procedures, such as third ventriculostomy (ETV), CC resection or aspiration, tumor biopsy or resection, septum pellucidotomy, and foraminoplasty or stenting, have been described. Endoscopic procedures are often described as minimally invasive, since they lead to lower morbidity and mortality rates when compared to open microsurgical procedures [5, 6]. Despite the growing preference of neuroendoscopic procedures for the treatment of hydrocephalus and intraventricular lesions, only few studies analyze variables such as cognitive and emotional deficits following these procedures [3, 4, 8,9,10,11,12,13,14,15,16]. The very few studies assessing for neurocognition in a systematic manner do not focus on neurocognitive decline caused by the surgery
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call