EFFICACY OF ENDOSCOPIC THIRD VENTRICULOSTOMY IN NONCOMMUNICATING HYDROCEPHALUS
Abstract
Background: Hydrocephalus is common problem requiring either extra-cranial (shunts) or intracranial (ventriculostomy) diversion of cerebrospinal fluid. Endoscopic third ventriculostomy obviatesall the complications of shunts and has been accepted as the procedure of choice for the treatment ofobstructed hydrocephalus in adults and children because of the minimally invasive nature. This studywas conducted to determine the efficacy of endoscopic third ventriculostomy in the treatment of noncommunicating hydrocephalus. Methods: This cross sectional descriptive study was done inneurosurgery department of Hayatabad Medical Complex, Peshawar, from 2nd February 2011 to 1stmarch 2012. A total of 171 patients with non-communicating hydrocephalous, irrespective of genderdiscrimination and Glasgow coma scale score of 10 and above were included in this study. Patientsbelow one year of age, with lesion in the floor of the third ventricle or near basilar artery, andhydrocephalus with infected CSF or haemorrhage were excluded. Hydrocephalous was diagnosed onCT-scan brain. All the patients were followed up till 72 hours post-operatively for the determination ofeffectiveness in terms of improvement in Glasgow coma scale by at least 2 points. All the abovementioned information including name, age, gender and address were recorded in a predesignedproforma. The data was analysed using SPSS-17. Frequency and percentage was calculated forcategorical variables. Mean±SD was calculated for age. Results: A total of 171 patients with noncommunicating hydrocephalous were included in the study. Out of 171 patients, there were 104(60.8%) males and 67 (39.2%) females. Age ranged from 1–70 years with majority of the patients wasbelow 10 years of age. Majority of the patients had hydrocephalus due to tuberculous meningitis 39.2%of the whole. In 134 (78.4%) patients the procedure was effective. Procedure was more effective inhydrocephalus due to space occupying lesion. Conclusion: Endoscopic third ventriculostomy is a veryeffective procedure for the treatment of non-communicating hydrocephalus.Keywords: Endoscopic third ventriculostomy, non-communicating hydrocephalus, effectiveness, shuntReferences
Woodworth GF, See A, Bettegowda C, Batra S, Jallo GI,
Rigamonti D. Predictors of surgery-free outcome in adult
endoscopic third ventriculostomy. World Neurosurg
;78:312–7.
Hailong F, Guagfu H, Haibin T, Hong P, Yong C, Weidong L, et
al. Endoscopic third ventriculostomy in the management of
communicating hydrocephalous, a preliminary study . J
Neurosurg 2008;109:923–30.
Baykan N, Isbir O, Gerçek A, Dagçnar A, Ozek MM. Ten years
of experience with pediatric neuroendoscopicthird
ventriculostomy: Features and perioperative complications of 210
cases. J Neuroserg Anesthesiol 2005;17:33–7.
Kulkarni AV, Hui S, Shams I, Donnelly R. Quality of life in
obstructive hydrocephalus: endoscopic third ventriculostomy
compared to cerebrospinal fluid shunt. Childs Nerv Syst
;26:75–9.
Aquilina K, Pople IK, Sacree J, Carter MR, Edwards RJ. The
constant flow ventricular infusion test: a simple and useful study
in the diagnosis of third ventriculostomy failure. J Neurosurg
;116:445–52.
Yadav YR, Parihar V, Pande S, Namdev H, Agarwal M.
Endoscopic third ventriculostomy. J Neurosci Rural Pract
;3:163–73.
J Ayub Med Coll Abbottabad 2012;24(2)
http://www.ayubmed.edu.pk/JAMC/24-2/Iftikhar.pdf
Moorthy RK, Rajshekhar V. Endoscopic third ventriculostomy
for hydrocephalus: a review of indications, outcomes, and
complications. Neurol India 2011;59:848–54.
Tubbs RS, Hattab EM, Loukas M, Chern JJ, Wellons M,
Wellons JC, et al. Histological analysis of the third ventricle floor
in hydrocephalic and nonhydrocephalic brains: application to
neuroendocrine complications following third ventriculostomy
procedures. J Neurosurg Pediatr 2012;9:178–81.
Durnford AJ, Kirkham FJ, Mathad N, Sparrow OC. Endoscopic
third ventriculostomy in the treatment of childhood
hydrocephalus: validation of a success score that predicts longterm outcome. J Neurosurg Pediatr 2011;8:489–93.
Dusick JR, Arthur DM, Berqsneider M. Success and
complication rates for adult hydrocephalus: a series of 108
patients. Surg neuol 2008;69(1):5–15.
Navarro R, Parra GR, Aoron J, Olavarria G, John A, Tomita T.
endoscopic third ventriculostomy in children early and late
complications and their avoidance. Child,s nervous
system.2007;22(5):506–13.
Brohi SR, Brohi AR, Sidiqui MA, Mughal SA, Saeed S.
Outcome of endoscopic third ventriculostomy in hydrocephalus.
J of surg pak 2010;15(1):25–8.
Sufianov AA, Sufianova GZ, Lakimov IA. Endoscopic third
ventriculostomy in patients younger than two years: outcome
analysis of 41 cases. J Neurosurg pediatr 2010;5:392–401.
Buxton N, Turners B, Ramli N, Vloeberghs M. changes in
ventricular size with neroendoscopic third ventriculostomy: A
blinded study. J Neurol Neurosurge Psychiatory 2002;72:385–7.
Gangemi M, Mascari C, Maiuri F, Godano U, DONATI P,
Longatti PL. Long term outcome of endoscopic third
ventriculostomy in obstructive hydrocephalus. Minim invasive
Neurosurge 2007;50:265–9.
Hellwig D, Grotenhuis JA, Tirakotai W, Riegel T, Schulte DM,
Bauer BL, Bertalanffy H. Endoscopic third ventriculostomy for
obstructive hydrocephalus. Neurosurg Rev 2005;28:1–34
Jinkenson MD, Havhurst C, Jumaily MA, Kandasamy J, Clark S,
Malucci CL. The role of endoscopic third ventriculostomy in
adult patients with obstructive hydrocephalus. J Neurosurg
;110:861–6.
Sacko O, Boetto S, Cances VL, Dupuy M, Roux FE. Endoscopic
third ventriculostomy, outcome analysis in 368 procedures. J
Neurosurg Pediatr 2010;5:68–74.
Downloads
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.