Document Detail


Endoscopic third ventriculostomy for shunt dysfunction in occlusive hydrocephalus: long-term follow up and review.
MedLine Citation:
PMID:  12744363     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: Endoscopic third ventriculostomy (ETV) is the treatment of choice for occlusive (noncommunicating) hydrocephalus. Nevertheless, its routine use in patients who have previously undergone shunt placement is still not generally accepted. The authors' aim was to investigate the long-term effects of ETV in a group of prospectively chosen patients. METHODS: Patients who underwent ETV and had previously undergone shunt placement for occlusive hydrocephalus were followed prospectively for at least 3 years (range 36-103 months, mean 63.6 months). Nine female and eight male patients ranging from 8 to 54 years of age (mean 32 years) had undergone shunt placement 0.7 to 23.5 years (mean 8.1 years) before ETV. Fifteen patients were admitted with underdrainage and two with overdrainage. In six cases, ETV was performed as an emergency operation. The origin of hydrocephalus was aqueductal stenosis in 12 cases and aqueductal compression by a tumor in two cases. Three patients suffered from a fourth ventricle outlet syndrome, and in two patients an additional malresorptive component was suspected. Thirteen patients underwent ETV with shunt removal and insertion of an external drain in one session. The drain served as a safety measure; it could be opened if raised intracranial pressure or ventricular dilation was observed on postoperative imaging studies. In the other four patients the shunt was initially ligated and then removed during a second operation. Fourteen patients (82%) have remained shunt free. The other three patients, including the two with an additional malresorptive component, needed shunt reimplantation 3 days, 2 weeks, or 7 months after ETV. CONCLUSIONS: Use of ETV is safe and effective for the treatment for shunt dysfunction in patients with obstructive hydrocephalus.
Authors:
Jürgen Boschert; Dieter Hellwig; Joachim K Krauss
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  98     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-05-14     Completed Date:  2003-06-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1032-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurosurgery, Inselspital, University of Bern, Switzerland. juergen.boschert@nch.ma.uni-heidelberg.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cerebrospinal Fluid Shunts*
Child
Device Removal
Endoscopy*
Equipment Failure
Female
Follow-Up Studies
Humans
Hydrocephalus / radiography,  surgery*
Male
Middle Aged
Pilot Projects
Postoperative Complications / radiography,  surgery*
Prospective Studies
Reoperation
Third Ventricle / surgery*
Tomography, X-Ray Computed
Ventriculostomy*
Comments/Corrections
Comment In:
J Neurosurg. 2003 Nov;99(5):940; author reply 940   [PMID:  14609182 ]

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


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