Naslov
Endoscopic third ventriculostomy - first experiences

Autori
Paladino, Josip ; Rotim, Krešimir ; Heinrich, Zdravko

Izvornik
Minimally invasive neurosurgery (0946-7211) 41 (1998);

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, ostalo

Ključne riječi
Hydroecphalus; Endoscopy; Ventriculostomy

Sažetak
Introduction: Endoscopic ventriculostomy is a minimally invasive technique, that establish a communication between third ventricle and subarachnoid space (interpeduncular cistern). The endoscopic intraventricular landmarks were the foramen of Monro, choroid plexus, anterior septal and thalamostriate veins, mamillary bodies, translucent floor of third ventricle, infundibular recess and optic recess. Methods: Authors retrospectively studied clinical files of 11 patients (M:F=7:4) operated on between September 1996 and December 1997. Patients ages ranged from 3 to 61 yr. Third ventriculostomy was performed in hydrocephalic patients with CT or MRI diagnosed noncommunicating hydrocephalus (aqueductal stenosis) and neurological signs of increased ICP. The fenestration instrument was a monopolar coagulation wire and dilation instrument was a balloon catheter. Results: All patients, but one, were able to remain independent of the shunt system after the ventriculostomy. A 3-yr. old boy, with history of meningitis, failed to improve clinically and CT scan showed no reduction in both lateral ventricle and third ventricle diameter. Subsequent ventriculoperitoneal drainage (PS Medical) was done. Post-operative third ventricle diameter is more reliable then lateral ventricle size, as an indicator of clinical improvement. There was no postoperative mortality. Conclusion: Endoscopic third-ventriculostomy is a low-risk neurosurgical technique that should be considered as the initial treatment of noncommunicating hydrocephalus. Features that increase patient's probability of success include age over 1-year, relatively recent obstruction, no meningitis or subarachnoid hemorrhage history and normal ventricular anatomy.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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