Document Detail

Hygromas after endoscopic third ventriculostomy in the first year of life: incidence, management and outcome in a series of 34 patients.
MedLine Citation:
PMID:  17619886     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Overdrainage in shunted patients is a known predisposing factor for the formation of hygromas, but little is known about risk factors in endoscopic third ventriculocisternostomy (ETV). MATERIALS AND METHODS: We retrospectively analysed data of 34 patients younger than 1 year with obstructive hydrocephalus, undergoing ETV, with respect to incidence, management, outcome and possible risk factors for the formation of hygromas. Hygromas were arbitrarily defined as a collection of cerebrospinal fluid of more than 10 mm in diameter over the paramedian hemispheric convexities, diagnosed by ultrasonography. RESULTS: They occurred in 9 of 34 (26%) patients 3 to 28 days after ETV. They were on the operated side in four and bi-lateral in five cases. There was no relevant age difference between patients with hygromas (median 127 days) and those without hygromas (median 166 days). Etiology of obstructive hydrocephalus had no impact on the frequency of hygromas. Hygromas occurred somewhat less frequently when a paediatric endoscope with an outer diameter of 3 mm was used for ETV instead of an endoscope with a diameter of 6 mm. Hygromas were asymptomatic and conservatively managed in five cases; 4 of 34 (12%) patients underwent surgery because of clinical symptoms of increasing intracranial pressure or increasing hygroma diameter. Two patients were treated with a temporary external drainage only and another two patients with an external drainage first and eventually a subduro-peritoneal shunt. There were no neurological long-term sequelae. CONCLUSION: Clear predisposing factors for the formation of hygromas could not be identified, but the outer diameter of the endoscope may play a role.
Dorothee Wiewrodt; Reinhard Schumacher; Wolfgang Wagner
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Publication Detail:
Type:  Journal Article     Date:  2007-07-10
Journal Detail:
Title:  Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery     Volume:  24     ISSN:  1433-0350     ISO Abbreviation:  Childs Nerv Syst     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-11-23     Completed Date:  2009-02-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8503227     Medline TA:  Childs Nerv Syst     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  57-63     Citation Subset:  IM    
Neurochirurgische Klinik und Poliklinik, Bereich Pädiatrische Neurochirurgie, Johannes Gutenberg-Universität, Langenbeckstr. 1, 55131, Mainz, Germany.
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MeSH Terms
Age Factors
Germany / epidemiology
Hydrocephalus / surgery*
Infant, Newborn
Lymphangioma, Cystic / diagnosis*,  epidemiology,  etiology
Neuroendoscopy / adverse effects,  methods*
Retrospective Studies
Risk Factors
Third Ventricle / surgery
Time Factors
Treatment Outcome
Ventriculostomy / adverse effects,  methods*

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