Document Detail

Is there an indication for ETV in young infants in aetiologies other than isolated aqueduct stenosis?
MedLine Citation:
PMID:  17047967     Owner:  NLM     Status:  MEDLINE    
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.
Donncha F O'Brien; Andrea Seghedoni; David R Collins; Caroline Hayhurst; Conor L Mallucci
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Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2006-09-19
Journal Detail:
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:
Created Date:  2007-01-11     Completed Date:  2007-03-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8503227     Medline TA:  Childs Nerv Syst     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1565-72     Citation Subset:  IM    
Department of Neurosurgery, Royal Liverpool Children's Hospital NHS Trust, Alder Hey, Eaton Road, Liverpool, L12 2AP, UK.
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MeSH Terms
Age Factors
Cerebral Aqueduct / pathology*,  surgery
Hydrocephalus / etiology*,  pathology,  surgery*
Infant, Newborn
Magnetic Resonance Imaging
Third Ventricle / surgery*
Tomography, X-Ray Computed
Treatment Outcome

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