8 Endoscopic third ventriculostomy: a surgeon's experience.
Subject: Cirugia endoscopica (Historia)
Cirugia endoscopica (Analisis de casos)
Cirugia endoscopica (Evaluacion)
Pub Date: 06/01/2009
Publication: Name: Puerto Rico Health Sciences Journal Publisher: Universidad de Puerto Rico, Recinto de Ciencias Medicas Language: Spanish Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2009 Universidad de Puerto Rico, Recinto de Ciencias Medicas ISSN: 0738-0658
Issue: Date: June, 2009 Source Volume: 28 Source Issue: 2
Geographic: Geographic Name: Puerto Rico
Accession Number: 201212357
Full Text: 8 Endoscopic Third Ventriculostomy: A Surgeon's Experience. Emil A Pastrana MD, Lincoln M Jimenez MD, Ivan J Sosa MD; Neurosurgery Section, Department of Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico. Introduction: Endoscopic third ventriculostomy (ETV) is considered an alternative treatment for certain types of hydrocephalus. Depending on patient's age and etiology of hydrocephalus, it can carry a success rate as high as 90 %. However, as in any surgical procedure inherent risks are present and a risk-benefit analysis must be taken prior to selecting patients for this intervention. Our objective was to evaluate retrospectively the experience of ETV at the University of Puerto Rico by examining the etiological factors, demographic data and symptoms among the Puerto Rican population. This study represents the data of one neurosurgeon and is the first account of Endoscopic third ventriculostomy as a mode of treatment in the Caribbean area. Method: A retrospective analysis of 29 patients treated in the University Pediatric Hospital (UPH) and University District Hospital (UDH) in San Juan was undertaken Different etiologies of hydrocephalus were identified and managed. Results: The most common indication for ETV was aqueductal stenosis (59%) with male gender predominance (55%). Also the most common population treated were adults (72%) and the most common symptoms of presentation were headache (52%) and gait disturbances (43%). Conclusion: Endoscopic third ventriculostomy is a safe and effective way to treat hydrocephalus and should be considered a first choice of treatment for certain patients with hydrocephalus unless otherwise contraindicated.
Table 1.
Characteristics

Sex
  Male                                   55%
  Female                                 45%
Age
  Mean                                  36 yrs
  Range                               0 - 81 yrs
  Mean Age - Males                      36 yrs
  Mean Age - Females                    54 yrs
  Pediatric (0-18 yrs) - Male            28%
  Pediatric (0-18 yrs) - Female           0%
  Adult (18 - 85 yrs) - Male             72%
  Adult (18 - 85 yrs) - Female           100%
Signs and Symptoms
  Adults
    Headaches                            52%
    Gait disturbances                    43%
    Altered mental status                29%
  Pediatrics
    increased head circumference         38%
Etiology
  Aqueductal stenosis                    59%
  Normal pressure hydrocephalus          17%
  Tumors                                 10%
  Others                                 14%
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