TRAITEMENT DE L’HyDROCEPHALIE TUMORALE PAR VENTRICULO-CISTERNOSTOMIE ENDOSCOPIQUE

Abstract

Endoscopic Third Ventriculostomy (ETV) is currently recognized as the treatment of choice for tumor hydrocephalus, used as an alternative to ventriculoperitoneal (VP) shunt because of the numerous complications associated with VP shunt. Patients and Methods: We conducted a retrospective study of 56 patients with hydrocephalus with tumor and treated by ETV over a period from February 2010 to July 2014 in the neurosurgery department of Fann University Hospital. Results: The frequency was 12 cases per year. The mean age of patients was 20.6 years with a male predominance with a sex ratio of 1, 55. Clinically, all our patients had intracranial hypertension syndrome and cerebellar syndrome was noted in 87.5% of cases. The diagnosis was made using the brain CT-scan in 80.36% of cases, supplemented by brain MRI in 17.85% of patients. The stoma was satisfactory in 54 patients. Tumor excision was performed secondarily in 22 patients. Immediate post-operative complications were noted in 10 patients. Twelve of our patients had benefited from a new treatment for hydrocephalus including 05 VP shunt and 07 external ventricular drainage (EVD). The ETV success rate was 80%. Conclusion: ETV prior to tumor resection in the management of hydrocephalus associated with tumor is controversial. But it is a reliable and effective surgical technique with very encouraging success rates in our context. Keys words: hydrocephalus, Endoscopic Third Ventriculostomy, posterior fossa tumours.