| Use of endoscopic third ventriculostomy in hydrocephalus of tubercular origin. | |
| | |
MedLine Citation:
|
PMID: 20508940 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
|
PURPOSE: The purpose of this paper was to study the feasibility of endoscopic third ventriculostomy (ETV) as a treatment modality in patients with hydrocephalus of tubercular origin. MATERIALS AND METHODS: Literature on ETV in hydrocephalus of tubercular origin has been reviewed, and we have gathered experiences of neurosurgeons from various institutions in our country practicing ETV. RESULTS: Hydrocephalus, a common complication of tubercular meningitis, may be of communicating type or of obstructive variety. The communicating type is treated by medical therapy in 70-92% cases, whereas the obstructive type requires surgical intervention. The outcome of surgery depends upon gradation of disease. Shunting however has been a nightmare for neurosurgeons treating such patients (Smyth et al., Pediatr Neurosurg 39: 258-263, 2003). The shunts tend to get blocked with debris. Having found ETV as a successful modality of treatment in obstructive hydrocephalus of other etiology, neurosurgeons have attempted it in hydrocephalus of tubercular origin. Though various authors have had a success rate of 65-68%, failure has been quite high in acute cases due to thickening of the floor of third ventricle and distorted anatomy. The success rate is higher in chronic and burnt out cases. CONCLUSION: Tubercular meningitic hydrocephalus is difficult to treat endoscopically as compared with other forms of meningitic hydrocephalus and requires adequate expertise and experience, especially in acute cases. Therefore, one would be justified in avoiding the use of ETV in acute cases and wait till patient presents with a failed shunt. Use of ETV in subacute and chronic cases seems to be justified as the first line of treatment. |
| | |
Authors:
|
Sanat Bhagwati; Nirav Mehta; Suneel Shah |
Publication Detail:
|
Type: Journal Article Date: 2010-05-28 |
Journal Detail:
|
Title: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery Volume: 26 ISSN: 1433-0350 ISO Abbreviation: Childs Nerv Syst Publication Date: 2010 Dec |
Date Detail:
|
Created Date: 2010-11-16 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8503227 Medline TA: Childs Nerv Syst Country: Germany |
Other Details:
|
Languages: eng Pagination: 1675-82 Citation Subset: IM |
Affiliation:
|
Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, India. bhagwatisanat@rediffmail.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The impact factor of rheumatology journals: an analysis of 2008 and the recent 10 years.
Next Document: Exercise training improves function of circulating angiogenic cells in patients with chronic heart f...