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Third Ventriculostomy

Neurosurgical Forum: Letters to the Editor To The Editor Yücel Kanpolat , M.D. Y. Şükrü Çağlar , M.D. Ankara, Turkey 511 512 We read with great interest and appreciation the recent article by Schwartz, et al., (Schwartz TH, Ho B, Prestigiacomo CJ, et al: Ventricular volume following third ventriculostomy. J Neurosurg 91: 20–25, July, 1999). In this report, based on a prospective study of 16 patients with noncommunicating hydrocephalus, the authors conclude that both third and lateral ventricular volumes decrease within the first 3 weeks after successful

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A new device for endoscopic third ventriculostomy

Technical note

Philippe Decq, Caroline Le Guerinel, Stéphane Palfi, Michel Djindjian, Yves Kéravel, and Jean-Paul Nguyen

S ince its first description by Dandy 3 in 1922 and its first realization under endoscopic control by Mixter 18 in 1923, third ventriculostomy has been more and more routinely performed for the treatment of non-communicating hydrocephalus 1, 2, 4, 6, 7, 11–13, 20, 21 After the works of Guiot, et al., 10 in 1963, the development of endoscopes made the procedure easier and safer than with radioscopic 5, 9 or stereotactic control alone. 15 The introduction of a rigid endoscope through a precoronal burr hole into the frontal horn of the lateral ventricle, and

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Transparent endoscopic sheath and rigid-rod endoscope used in endoscopic third ventriculostomy for hydrocephalus in the presence of deformed ventricular anatomy

Nakamasa Hayashi, Hideo Hamada, Kimiko Umemura, Kunikazu Kurosaki, Masanori Kurimoto, and Shunro Endo

E ndoscopic third ventriculostomies have been widely performed for the treatment of noncommunicating hydrocephalus. 2 , 4 , 5 , 9 , 12 In ETVs undertaken for the treatment of simple noncommunicating hydrocephalus, either a flexible or a rigid-rod endoscope can be used. A flexible endoscope fosters accessibility to and mobility in the ventricle, whereas the excellent visual quality afforded by the rigid-rod endoscope is advantageous for avoiding complications. Because the brilliant optical quality of the rigid-rod endoscope permits a relatively safe and

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Predicting success of endoscopic third ventriculostomy: validation of the ETV Success Score in a mixed population of adult and pediatric patients

Moujahed Labidi, Pascale Lavoie, Geneviève Lapointe, Sami Obaid, Alexander G. Weil, Michel W. Bojanowski, and André Turmel

E ndoscopic third ventriculostomy (ETV) represents an alternative to shunts in most cases of obstructive hydrocephalus. This procedure allows the CSF to be internally diverted to the basal cisterns and eventually be reabsorbed by arachnoid granulations, avoiding the need to implant exogenous material. The success rate of ETV is variable among series, with reported rates between 50% and 94%. In an exclusively adult population, the success rate seems to be somewhat higher, with 55% to 83% of the patients having satisfactory outcomes. However, relatively few

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Endoscopic third ventriculostomy with choroid plexus cauterization: predictors of long-term success and comparison with shunt placement for primary treatment of infant hydrocephalus

Benjamin C. Warf, Daniel S. Weber, Emily L. Day, Coleman P. Riordan, Steven J. Staffa, Lissa C. Baird, Katie P. Fehnel, and Scellig S. D. Stone

C ombined endoscopic third ventriculostomy (ETV) with choroid plexus cauterization (CPC) has provided an alternative to ventriculoperitoneal shunt (VPS) placement for hydrocephalus treatment in very young children since its introduction in 2005. 1 Moreover, its successful broader adoption, particularly in low-resource countries, as a new public health strategy for treating infant hydrocephalus was recently demonstrated. 2 Numerous studies from several sites have evaluated its efficacy in infants and with a variety of etiologies, including short

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Suprapineal recess: an alternate site for third ventriculostomy?

Case report

Roy Thomas Daniel, Gabriel Yin Foo Lee, and Peter Lawrence Reilly

E ndoscopic third ventriculostomies are increasingly performed for the treatment of obstructive noncommunicating hydrocephalus. High success rates of approximately 80% have been reported in several large series. With technological advances in endoscopic equipment, the indications for cranial neuroendoscopy have expanded to encompass the treatment of intracranial cysts, stent placement, and endoscopic-assisted microneurosurgery; however, third ventriculostomy is by far the most commonly performed neuroendoscopic procedure. The ventriculostomy puncture is

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Management of hydrocephalus in the patient with myelomeningocele: an argument against third ventriculostomy

Arthur E. Marlin

The majority of children with myelomeningocele will have associated hydrocephalus. The management of hydrocephalus can be one of the most trying problems in this patient population. Cerebrospinal fluid (CSF) diversion will be required in these children for the remainder of their lives. Blockage of the outlets of the fourth ventricle and communication of the fourth ventricle with the central canal provides a mechanism for compensation. The signs and symptoms of CSF diversion malfunction, either shunt or third ventriculostomy, can be quite subtle. The objective indications of these malfunctions are less available after third ventriculostomy than when using mechanical shunting. The ease with which the diagnosis of malfunction can be made becomes the major advantage of mechanical shunting over third ventriculostomy.

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Endoscopic third ventriculostomy and repeat endoscopic third ventriculostomy in pediatric patients: the Dutch experience

Gerben E. Breimer, Ruben Dammers, Peter A. Woerdeman, Dennis R. Buis, Hans Delye, Marjolein Brusse-Keizer, and Eelco W. Hoving

E ndoscopic third ventriculostomy (ETV) has become the standard treatment for obstructive hydrocephalus. 29 Its range of indications has extended to communicative hydrocephalus as well. 29 , 49 Unfortunately, to date, no treatment modality guarantees a permanent solution for hydrocephalus. 32 Therefore, when primarily treating hydrocephalus, the apparent benefits and disadvantages of ETV and shunting have to be weighted and considered. 10 , 16 , 18 , 30 , 36 , 38 , 41 , 61 To facilitate neurosurgeons in the process of patient selection for ETV, a predictive

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Endoscopic third ventriculostomy revision after failure of initial endoscopic third ventriculostomy and choroid plexus cauterization

Anastasia Arynchyna-Smith, Curtis J. Rozzelle, Hailey Jensen, Ron W. Reeder, Abhaya V. Kulkarni, Ian F. Pollack, John C. Wellons III, Robert P. Naftel, Eric M. Jackson, William E. Whitehead, Jonathan A. Pindrik, David D. Limbrick Jr., Patrick J. McDonald, Mandeep S. Tamber, Brent R. O’Neill, Jason S. Hauptman, Mark D. Krieger, Jason Chu, Tamara D. Simon, Jay Riva-Cambrin, John R. W. Kestle, Brandon G. Rocque, and for the Hydrocephalus Clinical Research Network

E ndoscopic third ventriculostomy (ETV) with choroid plexus cauterization (CPC) has shown promising results as a primary treatment for hydrocephalus in infants in East Africa. 1 , 2 A subsequent investigation of ETV+CPC in North America by the Hydrocephalus Clinical Research Network (HCRN) and other investigators reported varying success rates that were somewhat lower than earlier reports from Africa. 3 In 2018, the HCRN reported an initial ETV+CPC success rate of 36%. 4 More recently, the HCRN reported a success rate of 45% at 18 months, which was

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Spontaneous third ventriculostomy: definition by endoscopy and cerebrospinal fluid dynamics

Case report

Amit Parmar, Kristian Aquilina, and Michael R. Carter

S pontaneous ventriculostomy is a rare event and results from spontaneous rupture of a ventricle into the subarachnoid space in patients with chronic obstructive hydrocephalus. This often leads to resolution of the symptoms of hydrocephalus and to bypassing of the obstruction to the flow of CSF. 10 We report a case in which a spontaneous third ventriculostomy was inspected endoscopically and was shown to be associated with normal CSF dynamics despite the presence of aqueductal stenosis with severe triventricular hydrocephalus on imaging. Case Report