Abstract

EPORTS have amply demonstrated that third ventriculostomy can relieve acquired obstructive hydrocephalus, with a low operative morbidity and mortality2 The operation might be more widely used except for the fact that unpredictable failures occur from time to time. Although a number of authors have mentioned in passing that the perforations in the third ventricle sometimes seal, 5,8,t2 they have not analyzed the cause of failure or the criteria for the selection of patients. Consequently we performed postoperative encephalography with air, Pantopaque, or radioiodinated albumin in six cases in which third ventriculostomy was unsuccessful. These studies, and postmortem examinations in two more patients, demonstrated an obstruction of the subarachnoid cerebrospinal fluid pathways that accounted for the failure.

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