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J Neurol Surg A Cent Eur Neurosurg 2017; 78(03): 255-259
DOI: 10.1055/s-0036-1588063
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Influence of the State of the Subarachnoid Space of the Cranial Base in Hydrocephalus Resolution after Endoscopy

Jose Juan Sanchez Rodriguez
1   Department of Neurosurgery, Bathildis Krankenhaus Bad Pyrmont, Bad Pyrmont, Lower Saxony, Germany
,
Jaime Torres-Corzo
2   Department of Neurosurgery, Hospital Central Dr. Ignacio Morones Prieto, Mexico, San Luis Potosi, Germany
,
Dominic Shelby Cervantes
2   Department of Neurosurgery, Hospital Central Dr. Ignacio Morones Prieto, Mexico, San Luis Potosi, Germany
,
Roberto Rodriguez-DellaVecchia
2   Department of Neurosurgery, Hospital Central Dr. Ignacio Morones Prieto, Mexico, San Luis Potosi, Germany
,
Antonio Gordillo-Moscoso
3   Department of Clinical Epidemiology, Faculty of Medicine, San Luis Potosi, San Luis Potosi, Mexico
,
Juan Manuel Vinas-Rios
4   Department of Neurosurgery, University Clinic Evangelic Hospital Oldenburg, Oldenburg, Lower Saxony, Germany
,
Martin Sanchez-Aguilar
3   Department of Clinical Epidemiology, Faculty of Medicine, San Luis Potosi, San Luis Potosi, Mexico
› Author Affiliations
Further Information

Publication History

03 September 2015

27 May 2016

Publication Date:
29 September 2016 (online)

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Abstract

Objective To compare the resolution rate of hydrocephalus after endoscopy (predominantly endoscopic third ventriculostomy [ETV]) using flexible endoscopes during a 5-year period in patients with a permeable and a nonpermeable subarachnoid space (SAS).

Material and Methods We conducted a retrospective cohort study of the videos and records of 150 hydrocephalic patients chosen randomly who underwent ETV (and other endoscopic procedures) with a flexible endoscope. The patients were classified into two groups based on the neuroendoscopic findings. The first group included patients with a permeable SAS, and the second group included patients with a nonpermeable SAS. A normal SAS or one with slight arachnoiditis was considered permeable. Adhesive arachnoiditis and immature or mechanically obliterated SASs were considered nonpermeable.

Results We found a success rate of 70% in patients with a permeable SAS versus 33% in patients with a nonpermeable SAS. The baseline characteristics of both groups were homogeneous. We obtained a statistically significant difference (p < 0.0001) with hazard ratio (HR) 3.42 (95% confidence interval [CI], 1.88–6.22). Another important factor involved was age that showed a statistically significant difference (p < 0.0018) with HR 3.28 (95% CI, 1.55–6.93).

Conclusion The permeability of the SAS is an important prognostic factor in the resolution rate of hydrocephalus after ETV (and other endoscopic procedures) using flexible neuroendoscopes. Therefore we recommend that the characteristics of the SAS be examined following every endoscopic procedure for hydrocephalus to identify patients at risk of recurrence.

Keywords

flexible neuroendoscopy - hydrocephalus - third ventriculoscopy - subarachnoid space
 

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