Document Detail

Endoscopic third ventriculostomy in patients with a diminished prepontine interval.
MedLine Citation:
PMID:  20192641     Owner:  NLM     Status:  MEDLINE    
OBJECT: Fenestration of the floor of the third ventricle is vital to the success of endoscopic third ventriculostomy (ETV) in treating patients with noncommunicating hydrocephalus. A generous prepontine interval (PPI) is generally accepted as one anatomical feature that may affect the safety and functionality of ETV. Whether a diminished PPI influences the safety or success of ETV, however, has not been adequately assessed.
METHODS: A review was conducted on the last 100 ETV procedures performed by the first author (M.M.S.). From archived preoperative MR imaging studies, the PPI was measured between the dorsum sellae and the basilar artery. For any patient with an interval of <or=1 mm, the technical and functional success of the procedure was recorded. Technical success was defined when a surgically created fenestration was accomplished without patient morbidity. Functional success was defined as the patient not needing any additional CSF diversionary procedure within 3 months after ETV.
RESULTS: In the entire cohort, the PPI ranged from 0 to 9.5 mm (mean 3.2 mm). There were 15 procedures performed in patients with a PPI of <or=1 mm. In all 15 procedures, a fenestration of the tuber cinereum was accomplished without vascular injury or patient morbidity. The ETV was successful in 11 patients (73.3%). All 4 failures occurred in children who had surgery during infancy (mean age 11 months).
CONCLUSIONS: Patients with an obliterated or reduced PPI can safely undergo ETV. The functional success rate appears equivalent to historical controls. Most failures in this series may be attributed to other patient characteristics, namely young age at the time of ETV.
Mark M Souweidane; Peter F Morgenstern; Sungkwon Kang; Apostolos John Tsiouris; Jonathan Roth
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery. Pediatrics     Volume:  5     ISSN:  1933-0715     ISO Abbreviation:  J Neurosurg Pediatr     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-02     Completed Date:  2010-04-06     Revised Date:  2011-08-19    
Medline Journal Info:
Nlm Unique ID:  101463759     Medline TA:  J Neurosurg Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  250-4     Citation Subset:  IM    
Department of Neurological Surgery, Weill Cornell Medical College and Memorial Sloan-Kettering Cancer Center, New York 10021, USA.
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MeSH Terms
Child, Preschool
Cohort Studies
Hydrocephalus / etiology,  pathology,  surgery*
Middle Aged
Retrospective Studies
Sella Turcica
Subarachnoid Space
Third Ventricle / pathology*,  radiography,  surgery*
Treatment Outcome
Young Adult
Comment In:
J Neurosurg Pediatr. 2011 Jul;8(1):112-3; author reply 113-4   [PMID:  21721898 ]

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

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