Objectives: The aim of this study is to define the role and effectiveness for an endoscopic
third ventriculostomy (ETV) in patients with seconder normal pressure hydrocephalus(SNPH),
idiopathic normal pressure hydrocephalus (INPH) and symptomatic longstanding overt
ventriculomegaly (SLOVA). Materials and Methods: 3 patients with SLOVA, 3 patients with INPH and 3 patients with SNPH underwent ETV
were studied retrospectively. The patients had a follow-up of 1-6 years. Preoperative
CT or/and MRI of the brain was done in all cases.Tap test was done in all cases. Clinical
examination finding were classified according to the by Japanese Committee for Scientific
Research (JCSS) on intractable Hydrocephalus. Patients were studied to evaluate of
the patency of ventriculosthomy and aqueduclus slyvius by a Cine PC MR and CSF_DRİVE
T2 Sequence MRI after 1-6 years. Results: Headache, gait disturbance and pollakiuria improved in three patients with SNPH underwent
ETV, but dementia didn't improve in one patient. Pollakiuria and headache improved
in three patients with INPH underwent ETV but preoperative gait disturbance grade
three remained unchanged in one patient. Headache improved in three patients with
SLOVA underwent ETV. Preoperative gait disturbance grade 3 remained unchanged in one
patient, but improved pollakiuria. We confirmed the patency of a third ventriculostomy
and decreasing degrees of CSF flow into the aquaductus sylvius. Conclusions: In properly selected patients with SNPH, SLOVA and INPH who had headache ,slight
gait disturbance and pollakiuria , mainly those with a short duration of symptoms,
ETV may provide good results.
Key-words:
Endoscopic third ventriculostomy - hydrocephalus - idiopathic normal pressure hydrocephalus
- long-standing overt ventriculomegaly
