| Ventricular volume following third ventriculostomy. | |
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MedLine Citation:
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PMID: 10389875 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECT: Ventricular size often shows no obvious change following third ventriculostomy, particularly in the early postoperative period, making postoperative evaluation difficult without expensive and often invasive testing in patients with equivocal clinical responses. The authors hypothesized that performing careful volumetric measurements would show decreases in size within the first 3 weeks after surgery. METHODS: Volumetric measurements were calculated from standard 3 x 3-mm axial computerized tomography (CT) scans obtained immediately before and 3 and 21 days after surgery. Two independent investigators measured third ventricular volume in a series of 16 patients and lateral ventricular volume in 10 of the patients undergoing stereotactically guided endoscopic third ventriculostomy for noncommunicating hydrocephalus. Fifteen patients were symptomatically improved at the time the follow-up scan was obtained. Third ventricular volume decreased in all patients by a mean of 35% (range 7.8-95.1%) and lateral ventricular volume decreased in all patients by a mean of 33% (range 4.5-80.3%). The degree of change correlated with the length of preoperative symptoms (p < 0.005). The one patient who experienced no improvement showed no decrease in third ventricular volume. In seven of 10 patients, the decrease in third ventricular volume exceeded the decrease in lateral ventricular volume. Repeated measurements indicated that the 95% confidence interval for the authors' calculations varied around the mean by 2.5% for third ventricular volume and 1.2% for lateral ventricular volume. Long-term outcome was excellent, with only one case of delayed failure. The mean follow-up duration was 12 months. CONCLUSIONS: Volumetric measurements calculated from standard CT scans will show a demonstrable decrease in ventricular volume soon after successful third ventriculostomy and can be helpful in assessing patients postoperatively. Although the third ventricle may exhibit a greater decrease, the lateral ventricular measurements are more accurate. Patients with more indolent symptoms show the smallest change. |
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Authors:
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T H Schwartz; B Ho; C J Prestigiacomo; J N Bruce; N A Feldstein; R R Goodman |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of neurosurgery Volume: 91 ISSN: 0022-3085 ISO Abbreviation: J. Neurosurg. Publication Date: 1999 Jul |
Date Detail:
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Created Date: 1999-07-06 Completed Date: 1999-07-06 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0253357 Medline TA: J Neurosurg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 20-5 Citation Subset: AIM; IM |
Affiliation:
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Department of Neurological Surgery, The Neurological Institute of New York, Columbia-Presbyterian Medical Center, New York 10032, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Cerebral Ventricles / pathology*, surgery Child Child, Preschool Endoscopy Female Humans Hydrocephalus / pathology*, surgery Infant Male Middle Aged Prospective Studies Stereotaxic Techniques Treatment Outcome Ventriculostomy* / methods |
| Comments/Corrections | |
Comment In:
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J Neurosurg. 2000 Mar;92(3):511-2
[PMID:
10701554
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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