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Third Ventriculostomy

Neurosurgical Forum: Letters to the Editor To The Editor W. Peter Vandertop , M.D. Amsterdam, The Netherlands A. van der Zwan , M.D. Rudolf M. Verdaasdonk , Ph.D. Utrecht, The Netherlands 919 921 Abstract Since its description by Dandy in 1922, several techniques have been used to perform third ventriculostomy under endoscopic control. Except for the blunt technique, in which the endoscope is used by itself to create the opening in the floor of the third ventricle, the other

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Death after late failure of third ventriculostomy in children

Report of three cases

Walter J. Hader, James Drake, Douglas Cochrane, Owen Sparrow, Edward S. Johnson, and John Kestle

C omplications associated with the treatment of ob-Vancouver, Canada, or the Southampton General Hospital, structive hydrocephalus with third ventriculostomy Southampton, United Kingdom, and who had died after unare uncommon, 3, 7, 11, 18 but they are often serious in dergoing a successful third ventriculostomy for obstructive nature, 1, 2, 8, 14 although they are rarely fatal. 16 Late failure of hydrocephalus. Patient records were obtained and the folthird ventriculostomy is often heralded by the recurrence of lowing data were recorded: diagnosis, age at

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Imaging correlates of successful endoscopic third ventriculostomy

Abhaya V. Kulkarni, James M. Drake, Derek C. Armstrong, and Peter B. Dirks

no change between the pre- and postoperative scores yielded probability values of less than 0.0001 for Group 1 and 0.02 for Group 2. However, the difference between Group 1 and Group 2 was not significant (p = 0.43). Discussion Endoscopic third ventriculostomy is gaining popularity as an alternative to CSF shunt placement in selected cases of hydrocephalus. One unresolved issue that emerges during follow-up examination of a patient who has undergone ETV is determining the imaging correlates of failure and success. The two particular correlates of interest have been

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Third Ventriculostomy

Neurosurgical Forum: Letters to the Editor To The Editor Vitaly Siomin , M.D. Shlomi Constantini , M.D. Tel-Aviv Sourasky Medical Center Tel Aviv, Israel 940 940 Abstract Object. Endoscopic third ventriculostomy (ETV) is the treatment of choice for occlusive (noncommunicating) hydrocephalus. Nevertheless, its routine use in patients who have previously undergone shunt placement is still not generally accepted. The authors' aim was to investigate the long-term effects of ETV in a group of

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Death and Third Ventriculostomy

Neurosurgical Forum: Letters to the Editor To The Editor Richard J. Edwards , F.R.C.S. Ian K. Pople , M.D., F.R.C.S.(SN) Frenchay Hospital Bristol, United Kingdom 649 651 Abstract Late failure following successful third ventriculostomy for obstructive hydrocephalus is rare, and death caused by failure of a previously successful third ventriculostomy has been reported only once. The authors present three patients who died as a result of increased intracranial pressure (ICP) after late failure of

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Cavitation-based third ventriculostomy using MRI-guided focused ultrasound

Laboratory investigation

Ryan Alkins, Yuexi Huang, Dan Pajek, and Kullervo Hynynen

T reatment options for hydrocephalus include CSF shunting procedures or endoscopic third ventriculostomy (ETV). In the developed world, ETV is often the preferred treatment for obstructive hydrocephalus as it avoids shunt dependency and the need for permanently implanted hardware. 6 In the developing world, ETV is even more desirable, given the barriers to accessing timely and competent neurosurgical care in the event of shunt malfunction or infection. Endoscopic third ventriculostomy is not without risk, however, with morbidity and mortality reported in

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Use of microvascular Doppler probe to avoid basilar artery injury during endoscopic third ventriculostomy

Technical note

Richard H. Schmidt

) injury in one of 46 patients whom they treated using a nonendoscopic technique. Injury to perforating vessels arising from the BA apex may also help explain cases of postoperative hemiparesis and midbrain damage encountered by Jones et al., 7 as reported in their series. Vascular injury that occurs during third ventriculostomy is related to the proximity of the BA apex and proximal PCAs to the floor of the third ventricle, where they could be damaged by either direct penetration or traction-related avulsion. The key to avoiding this complication is to understand the

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Successful neuroendoscopic third ventriculostomy for hydrocephalus and syringomyelia associated with fourth ventricle outlet obstruction

Case report

Takaichi Suehiro, Takanori Inamura, Yoshihiro Natori, Masayuki Sasaki, and Masashi Fukui

F ourth ventricle outlet obstruction is a rare syndrome that is associated with hydrocephalus and syringomyelia, which are frequently found in patients with Chiari malformation; such an obstruction is caused by chronic tonsillar herniation. 17 Symptomatic hydrocephalus and syringomyelia have been treated by decompression of the posterior fossa, ventriculoperitoneal or Torkildsen shunt placement, and neuroendoscopic third ventriculostomy. 3, 19 We report on a patient in whom neuroendoscopic third ventriculostomy was used successfully to treat hydrocephalus and

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Acute distortion of the anatomy of the third ventricular during third ventriculostomy

Report of four cases

Jasper van Aalst, Emile A. M. Beuls, Ferenc A. van Nie, Johan S. H. Vles, and Erwin M. J. Cornips

C hronic hydrocephalus due to primary aqueductal stenosis is one of the most popular indications for endoscopic third ventriculostomy. 2, 5, 7, 8, 20 A wealth of technical details 4, 9, 12, 14–16, 22–25 and complications concerning ETV have been reported, including the site and size of the perforation, 26 how to make the perforation, which precautions to take to avoid bradycardia, 6 vascular 1, 3, 10, 17, 18, 21 or hypothalamic 19 lesions, and the occurrence of subdural collections after ETV. 11, 13 Special attention is required to avoid creating

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Management of hydrocephalus in pediatric patients with posterior fossa tumors: the role of endoscopic third ventriculostomy

Christian Sainte-Rose, Giuseppe Cinalli, Franck E. Roux, Wirginia Maixner, Paul D. Chumas, Maher Mansour, Alexandre Carpentier, Marie Bourgeois, Michel Zerah, Alain Pierre-Kahn, and Dominique Renier

obstructive nature of the hydrocephalus associated with these tumors, internal CSF diversion is appealing. 4, 11 Despite this, third ventriculostomy remains an underused procedure for a number of reasons. Although the obstructive hydrocephalus may be controlled prior to tumor resection, there is a paucity of evidence regarding the site of interference of CSF dynamics after resection, thus making the long-term efficacy of the procedure unknown. More important, there is the issue of safety when performing a third ventriculostomy in a patient harboring a large posterior fossa