Document Detail


Changes in ventricular size after endoscopic third ventriculostomy.
MedLine Citation:
PMID:  18176776     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: There is general consensus that a successful endoscopic third ventriculostomy is usually followed by a decrease of ventricular size without reaching their normal size. This study was performed to determine how the change related to clinical outcome, how it developed chronologically and whether the change in ventricular size was different in acute and chronic forms of hydrocephalus. METHOD: Fifty-five of 74 patients who had undergone endoscopic third ventriculostomy during the period 1997-2004 were selected by the criterion that they had both pre-operative and post-operative films and no neurosurgical manoeuvre other than a surgically successful endoscopic third ventriculostomy in the time span between both radiological studies. Ventricular size was measured with the Evans index, third ventricle index, cella media index and ventricular score. Median age was 51 years (interquartile range, 27-65 years). RESULTS: The change in ventricular size detected shortly after surgery is related to clinical outcome for all ventricular ratios, except the cella media index (p = 0.08). When third ventriculostomy is clinically successful, there is a gradual decrease of ventricular size over a period of more than three months (p < 0.0001 for all ventricular ratios). The reduction is more prominent in acute hydrocephalus than in chronic forms for all ventricular ratios, except the Evans index (p = 0.12). The third ventricle exhibits the greatest reduction (25% with a 95% confidence interval: 15.4-34.5) and determines a different pattern of change in ventricular size after endoscopic third ventriculostomy between acute and chronic hydrocephalus. CONCLUSIONS: A decrease of the ventricular size detected soon after endoscopic third ventriculostomy is associated with a satisfactory clinical outcome. This response continues during the first few months after surgery. The reduction is more prominent in acute forms of hydrocephalus.
Authors:
D Santamarta; J Martin-Vallejo; A Díaz-Alvarez; A Maillo
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Publication Detail:
Type:  Journal Article     Date:  2008-01-08
Journal Detail:
Title:  Acta neurochirurgica     Volume:  150     ISSN:  0942-0940     ISO Abbreviation:  Acta Neurochir (Wien)     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-07     Completed Date:  2008-03-27     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0151000     Medline TA:  Acta Neurochir (Wien)     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  119-27; discussion 127     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Hospital Universitario de Salamanca, Salamanca, Spain. dsantamarta@hleo.sacyl.es
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Chronic Disease
Endoscopy*
Female
Follow-Up Studies
Humans
Hydrocephalus / diagnosis,  etiology,  surgery*
Male
Middle Aged
Organ Size
Third Ventricle / pathology*,  surgery*
Time Factors
Treatment Outcome
Ventriculostomy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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