Document Detail

Death after late failure of endoscopic third ventriculostomy: a potential solution.
MedLine Citation:
PMID:  12925256     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Late failure after successful third ventriculostomy is rare, and death caused by failure of a previously successful third ventriculostomy has been reported on four occasions. We describe a simple innovation that adds little morbidity and has the potential to reduce the advent of death after late failure of endoscopic third ventriculostomy. METHODS: After endoscopic fenestration of the floor of the third ventricle, a ventricular catheter and subcutaneous reservoir are placed via the endoscope path. With acute blockage and neurological deterioration, cerebrospinal fluid can be removed via needle puncture of the reservoir until consultation with a neurosurgeon. RESULTS: From 1979 to 2003, more than 240 endoscopic third ventriculostomies have been performed at our institution, with one death after late failure. The revised technique was devised after this death and has been performed on 21 patients to date. CONCLUSION: The addition of a reservoir adds little time and morbidity to the procedure and offers the potential to sample cerebrospinal fluid, measure intracranial pressure, and reduce mortality associated with late failure of endoscopic third ventriculostomy.
Ralph J Mobbs; Marianne Vonau; Mark A Davies
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Neurosurgery     Volume:  53     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-08-19     Completed Date:  2003-09-17     Revised Date:  2008-02-21    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  384-5; discussion 385-6     Citation Subset:  IM    
The Prince of Wales Hospital, Sydney, New South Wales, Australia.
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MeSH Terms
Endoscopy / methods*,  mortality*
Hydrocephalus / mortality*,  surgery*
Third Ventricle / surgery*
Time Factors
Treatment Failure*
Ventriculostomy / methods*,  mortality*
Comment In:
Neurosurgery. 2005 Apr;56(4):E873   [PMID:  15818883 ]
Neurosurgery. 2005 Mar;56(3):E629   [PMID:  18235262 ]

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

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