Abstract
Abstract: The indication for endoscopic third ventriculostomy(ETV) includes almost any hydrocephalus. Depending on theunderlying pathology, a highly variable outcome has beenreported. Here, the authors present their experience with ETV inthe treatment of hydrocephalus after application of thistechnique for 13 years. Between January 1993 and October2005, 271 third ventriculostomies were undertaken. Indicationsincluded obstructive hydrocephalus caused by tumor, aqueduc-tal stenosis, hemorrhage and brain infarction, and selected casesof communicating hydrocephalus. A standard endoscopicventriculostomy was performed at the floor of the thirdventricle, consisting of a blunt perforation and subsequentenlargement of the stomy with a balloon catheter. The mean ageof the patients was 41 years with a range from 1 day up to 85years. Overall, symptoms improved clinically in 69% and theventricular size decreased in 64%. In 1 case, the procedure hadto be abandoned. The success rate of the procedure dependedhighly on the underlying pathology (116 cases with obstructivehydrocephalus caused by tumor, 81% success rate; 56 cases withaqueductal stenosis, 73% success rate; 35 cases of intraven-tricular hemorrhage, 66% radiologic improvement; 15 caseswith cerebellar infarction and fourth ventricular malformationeach and a success rate of 86% and 53% respectively; 35%clinical improvement in 23 cases communicating hydrocephalus;50% improvement in 4 cases associated with myelomeningo-cele). Complications included 2 deaths (0.7%) and 4 permanentdeficits (1.5%). In all, ETV represents a safe and reliableprocedure for hydrocephalus treatment. It is the procedure ofchoice for obstructive hydrocephalus.Key Words: third ventriculostomy, hydrocephalus, neuroendo-scopy, aqueductal stenosis, pediatric neuroendoscopy(Neurosurg Q 2006;16:24–31)
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