Minim Invasive Neurosurg 2010; 53(3): 106-111
DOI: 10.1055/s-0030-1251983
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic Third Ventriculostomy in Patients with Secondary Triventricular Hydrocephalus from a Haemorrhage or Ischaemia in the Posterior Cranial Fossa

M. Vindigni1 , F. Tuniz1 , T. Ius1 , A. Cramaro1 , M. Skrap1
  • 1Department of Neurosurgery, Azienda Ospedaliero Universitaria di Udine, Udine, Italy
Further Information

Publication History

Publication Date:
31 August 2010 (online)

Abstract

Background: The aim of this project was to evaluate the efficacy of endoscopic third ventriculostomy (ETV) in the treatment of acute hydrocephalus caused by a haemorrhage or ischaemia in the posterior cranial fossa.

Methods: 21 patients who had acute triventricular hydrocephalus resulting from ischaemia in 8 cases, and from cerebellar haemorrhage in 13 cases were treated with endoscopic third ventriculostomy. This series was compared with a control group of 30 patients, with clinical neuroradiological characteristics comparable to the preceding group (18 acute post-haemorrhage hydrocephalus and 12 post-ischaemia in the posterior cranial fossa), treated by external ventricular drainage (EVD). All patients were monitored clinically and by brain computed axial tomography (CT) to measure the dimensions of the lateral and third ventricles. The criteria used to define efficacy were based on the image of the postoperative cerebral CT scan.

Results: No patient suffered haemorrhagic complications from surgical procedures or additional neurological deficits. There was no postoperative mortality or added morbidity. In all cases there was an improvement of intracranial hypertension. Clinical improvement was associated with a reduction of the ventricular dimensions documented by serial CT scans.

Conclusions: We consider that, in selected cases, ETV can be suggested as the first choice treatment instead of the classic EVD. In the overall management of such patients, ETV has no or a very low rate of complications and allows shorter hospitalisation and earlier transfer to rehabilitative structures.

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Correspondence

M. VindigniMD 

Department of Neurosurgery

Azienda Ospedaliero

Universitaria di Udine

Piazzale S. Maria della

Misericordia

33100 Udine

Italy

Phone: +39/043/255 2701

Fax: +39/043/255 2700

Email: vindigni.marco@aoud.sanita.fvg.it