| Is there an indication for ETV in young infants in aetiologies other than isolated aqueduct stenosis? | |
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MedLine Citation:
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PMID: 17047967 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The objective was to determine whether endoscopic third ventriculostomy (ETV) has a role in the management of obstructive hydrocephalus in aetiologies other than idiopathic aqueduct stenosis (AS) in infants. MATERIALS AND METHODS: In addition to reviewing the literature, we performed a retrospective analysis of our endoscopy database, which was established in 1998, and analysed the outcome results of all cases of ETV in those under 1 year of age which were performed between 1998 and 2003. We included cases of idiopathic AS in the outcome analysis as a benchmark of successful outcome. Successful outcome was assessed by resolution of the presenting clinical features and shunt freedom. RESULTS: Aetiologies that were identified included, in addition to idiopathic AS, suprasellar arachnoid cysts, AS in association with post-haemorrhagic hydrocephalus (PHH), post-infectious hydrocephalus (PIH), tumour-related hydrocephalus and a heterogenous group including Dandy-Walker malformation and other developmental anomalies. Suprasellar arachnoid cysts had a 100% outcome success. Idiopathic AS had a 50% outcome success and the successful outcome of PHH cases was poor at 18%. A statistical analysis revealed no effect of age at the time of ETV on the outcome in the aetiological groups. CONCLUSIONS: The definitive initial neurosurgical management of suprasellar arachnoid cysts causing significant hydrocephalus is ETV, whereas that for PHH and PIH is probably that of a ventriculo-peritoneal shunt placement. We speculate that there may be a sub-group of AS cases, termed pure or idiopathic AS, which have a higher rate of successful outcome that may be durable from a younger age. The role of repeat ETV is controversial. |
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Authors:
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Donncha F O'Brien; Andrea Seghedoni; David R Collins; Caroline Hayhurst; Conor L Mallucci |
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Publication Detail:
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Type: Case Reports; Journal Article; Review Date: 2006-09-19 |
Journal Detail:
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Title: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery Volume: 22 ISSN: 0256-7040 ISO Abbreviation: Childs Nerv Syst Publication Date: 2006 Dec |
Date Detail:
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Created Date: 2007-01-11 Completed Date: 2007-03-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8503227 Medline TA: Childs Nerv Syst Country: Germany |
Other Details:
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Languages: eng Pagination: 1565-72 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Royal Liverpool Children's Hospital NHS Trust, Alder Hey, Eaton Road, Liverpool, L12 2AP, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Age Factors Cerebral Aqueduct / pathology*, surgery Endoscopy* Humans Hydrocephalus / etiology*, pathology, surgery* Infant Infant, Newborn Magnetic Resonance Imaging Third Ventricle / surgery* Tomography, X-Ray Computed Treatment Outcome Ventriculostomy* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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