Download PDF
Minim Invasive Neurosurg 2000; 43(2): 75-82
DOI: 10.1055/s-2000-8323
ÜBERSICHT
Georg Thieme Verlag Stuttgart · New York

Endoscopic Third Ventriculostomy: Towards More Indications for the Treatment of Non-Communicating Hydrocephalus

W. R. Murshid
  • Department of Surgery, King Khalid University Hospital, Riyadh, Saudi Arabia
Further Information

Publication History

Publication Date:
31 December 2000 (online)

    Permissions and Reprints

Objective: Since its reintroduction during the last 2 decades, third ventriculostomy has shown promising results. However, with more experience and better selection of cases, the indications and contraindications are likely to change. Methods: During the period from November 1994 to December 1996, we have treated 27 patients with non-communicating hydrocephalus by endoscopic third ventriculostomy at the King Khalid University Hospital. Their ages ranged from 35 weeks preterm to 26 years of age. Sixteen (59 %) patients were one year old or younger. Their follow-up ranged from 9 months to 2.5 years. According to the etiology of the non-communicating hydrocephalus, patients were divided into 4 subgroups. These were as follows: 11 aqueduct stenosis, 6 post ventriculitis, 6 cysts, and 4 posterior fossa tumours. The outcome was graded into 3 grades: Grade III were patients who improved after the procedure. Grade II were patients who improved after adding a VP-shunt to the procedure. Grade I were failure patients. Results: An overall outcome of Grade III was achieved in 22 patients (81 %). This was broken down according to subgroups as follows: 8/11 (73 %) patients of subgroup 1, 5/6 in each of the patients of subgroup 2 and 3, and all of the patients with posterior fossa tumours. Discussion: The overall results were very encouraging and so for the subgroups as compared with the reported cases in the literature. Conclusion: Better selection of the cases and increased experience with the procedure is expected to improve the outcome.

Key words:

Endoscope - Hydrocephalus - Ventriculostomy - Endoscopic Third Ventriculostomy

References

  • 1 Auer L M, Holzer P, Ascher P W, Heppner F. Endoscopic neurosurgery.  Acta Neurochir (Wien). 1988;  90 1-14
    CrossrefPubMedGoogle Scholar
  • 2 Baskin J J, Manwaring K H, Rekate H L. Ventricular shunt removal: the ultimate treatment of the slit ventricle syndrome.  J Neurosurg. 1998;  88 478-484
    PubMedGoogle Scholar
  • 3 Caemaert J, Abdullah J, Calliauw L. Endoscopic treatment of suprasellar arachnoid cysts.  Acta Neurochir. 1992;  119 68-73
    CrossrefPubMedGoogle Scholar
  • 4 Cohen A R. Ventriculoscopic surgery. In: Loftus CM (ed.). Clinical Neurosurgery: Proceedings of the Congress of Neurological Surgeons British Columbia: Williams and Wilkins 1994: 546-562
    Google Scholar
  • 5 Culley D J, Berger M S, Shaw D, Geyer R. An analysis of factors determining the need for ventriculo-peritoneal shunt after posterior fossa tumours surgery in children.  Neurosurgery. 1994;  34 402-408
    PubMedGoogle Scholar
  • 6 Drake J M. Ventriculostomy for treatment of hydrocephalus. In: Butler AB, McLone DG (eds.). Neurosurgery clinics of North America Philadelphia: W. B. Saunders Company 1993: 666-667
    Google Scholar
  • 7 Guiot G. Ventriculo-cisternostomy for stenosis of the aqueduct of Sylvius.  Acta Neurochir (Wien). 1973;  28 275-289
    CrossrefPubMedGoogle Scholar
  • 8 Hirsch J F. Percutaneous ventriculo-cisternostomies in non-communicating hydrocephalus.  Monogr Neurol Sci. 1982;  8 170-178
    PubMedGoogle Scholar
  • 9 Hirsch J F, Hirsch E, Sainte-Rose C, Renier D, Pierre-Kahn A. Stenosis of the aqueduct of Sylvius: etiology and treatment.  J Neurosurg Sci. 1986;  30 29-39
    PubMedGoogle Scholar
  • 10 Hoffman H J, Harwood-Nash D, Gilday D L. Percutaneous third ventriculostomy in the management of non-communicating hydrocephalus.  Neurosurgery. 1980;  7 313-321
    PubMedGoogle Scholar
  • 11 Jaksche H, Loew F. Burr-hole third ventriculo-cisternotomy.  Acta Neurochir (Wien). 1986;  79 47-51
    PubMedGoogle Scholar
  • 12 Jones R FC, Stening W A, Brydon M. Endoscopic third ventriculostomy.  Neurosurgery. 1990;  26 86-92
    CrossrefPubMedGoogle Scholar
  • 13 Jones R FC, Teo C, Stening W A, Kwok B CT. Neuroendoscopic third ventriculostomy. In: Manwaring KH, Crone KR (eds.). Neuroendoscopy, Vol. 1 New York: Mary Ann Liebert 1992: 63-77
    Google Scholar
  • 14 Jones R FC, Stening W A, Kwok B C, Sands T M. Third ventriculostomy for shunt infections in children.  Neurosurgery. 1993;  32 855-859; discussion: 860
    CrossrefPubMedGoogle Scholar
  • 15 Jones R FC, Kwok B C, Stening W A, Vonau M. The current status of endoscopic third ventriculostomy in the management of non-communicating hydrocephalus.  Minim Invas Neurosurg. 1994;  37 28-36
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Jones R FC, Kwok B C, Stening W A, Vonau M. Neuroendoscopic third ventriculostomy: A practical alternative to extracranial shunts in non-communicating hydrocephalus.  Acta Neurochir Suppl. 1994;  61 79-83
    PubMedGoogle Scholar
  • 17 Jones R FC, Kwok B CT, Stening W A, Vonau M. Third ventriculostomy for hydrocephalus associated with spinal dyspharism: Indications and contraindications.  Eur J Pediatr Surg. 1996;  6 Suppl I 5-6
    PubMedGoogle Scholar
  • 18 Kelly P J, Jack Jr C R. Stereotactic third ventriculostomy in patients with non-tumoural adolescent/adult onset aqueductal stenosis and symptomatic hydrocephalus.  J Neurosurg. 1991;  75 865-873
    CrossrefPubMedGoogle Scholar
  • 19 Kunz U, Goldmann A, Bader C, Waldbaur H, Oldenkott P. Endoscopic fenestration of the third ventricular floor aqueduct stenosis.  Minim Invas Neurosurg. 1994;  37 42-47
    PubMedGoogle Scholar
  • 20 Lee M, Wisoff J H, Abbott R, Freed D, Epstein F J. Management of hydrocephalus in children with medulloblastoma: prognostic factors for shunting.  Pediatr Neurosurg. 1994;  20 240-247
    PubMedGoogle Scholar
  • 21 Lewis A I, Larson J J, Crone K R. Endoscopic treatment of complex hydrocephalus.  Techniques in Neurosurgery. 1996;  1 168-175
    PubMedGoogle Scholar
  • 22 Mixter T H. Ventriculoscopy and puncture of the floor of the third ventricle.  Boston Med Surg J. 1923;  188 277-278
    PubMedGoogle Scholar
  • 23 Natelson S E. Early third ventriculostomy in myelomeningocele infants: Shunt independence.  Child's Brain. 1981;  8 321-325
    PubMedGoogle Scholar
  • 24 Powers S K. Fenestration of intraventricular cyst using a flexible, steerable endoscope.  Acta Neurochir Suppl. 1992;  54 42-46
    PubMedGoogle Scholar
  • 25 Sainte-Rose C. Third ventriculostomy. In: Manwaring KH, Crone KR (eds.). Neuroendoscopy New York: Mary Anne Liebert 1992: 47-62
    Google Scholar
  • 26 Sainte-Rose C, Chumas P. Endoscopic third ventriculostomy. Techniques in.  Neurosurgery. 1996;  1 176-184
    PubMedGoogle Scholar
  • 27 Schwartz T H, Yoon S S, Cutruzzola F W, Goodman R R. Third ventriculostomy: post-operative ventricular size and outcome.  Minim Invas Neurosurg. 1996;  39 122-129
    PubMedGoogle Scholar
  • 28 Vries J. An endoscopic technique for third ventriculostomy.  Surg Neurol. 1978;  9 165-168
    PubMedGoogle Scholar
  • 29 Vries J K, Friedman W A. Post operative evaluation of third ventriculostomy patients using 111 In-DTPA.  Child's Brain. 1980;  6 (4) 200-205
    PubMedGoogle Scholar
  • 30 Yamamoto M, Oka K, Idea K, Tomonaga M. Percutaneous flexible neuroendoscopic ventriculostomy in patients with shunt malfunction as an alternative procedure to shunt revisions.  Surg Neurol. 1994;  42 218-223
    CrossrefPubMedGoogle Scholar

Corresponding Author

Dr W R Murshid, FRCSEd (SN)

Consultant Neurosurgeon Department of Surgery King Khalid University Hospital

P. O. Box 7805 Riyadh 11472 Saudi Arabia

Phone: Phone:+966-1-4671584

Fax: Fax:+966-1-4679493

Email: E-mail: wmurshid@ksu.edu.sa

      >