Conventional valve shunting for treatment of hydrocephalus has a high rate of long-term
complications. Endoscopic ventriculostomy by fenestration of the third ventricular
floor, a minimally-invasive technique, avoids many of the drawbacks of extracranial
shunting. Endoscopy was performed in 12 hydrocephalic patients with MRI-diagnosed
aqueductal stenosis and neurological signs. Intraoperative ultrasound guidance allowed
aiming the tip of the rigid endoscope to the foramen of Monro, and direct entering
of the enlarged third ventricle. This technique is as exact as stereotaxy but is faster
and easier. No complications were seen due to the surgical procedure. Nine patients
were cured from their complaints, in 3 cases there was a subjective improvement of
neurology. Long-term patency of the third ventriculostomy was confirmed by movement-sensitive
MRI.
Endoscopy - Hydrocephalus - Intraoperative Ultrasound - Stenosis of Aqueduct - Ventriculostomy
