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Intraoperative assessment of endoscopic third ventriculostomy success

Clinical article

Jeffrey P. Greenfield, Caitlin Hoffman, Eugenia Kuo, Paul J. Christos, and Mark M. Souweidane

. When the fenestration created was judged to be sufficient, the endoscope was used to evaluate the prepontine subarachnoid space for the presence of scarring or adhesions and unfenestrated membranes of Liliequist. If necessary, blunt perforation and balloon dilation could be used on scarred or adherent membranes in a fashion similar to that used on the floor of the third ventricle. At the completion of the procedure irrigation, was briefly held. The adequacy of the third ventriculostomy was then judged by the to-and-fro motion of the free edges of the fenestrations

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Changes in cerebral perfusion hormone profile and cerebrospinal fluid flow across the third ventriculostomy after endoscopic third ventriculostomy in patients with aqueductal stenosis: a prospective study

Clinical article

Anil Kumar Garg, Ashish Suri, Bhavani S. Sharma, Shamin A. Shamim, and Chander S. Bal

denuding of the ependyma. 23 , 27 , 28 There are few conditions treated by neurosurgeons that are at once so gratifying and as frustrating as hydrocephalus. Treatment of hydrocephalus has seen more advances during the last century than any neurosurgical condition. Advancements in endoscopic techniques have led to a revival of third ventriculostomy in the management of hydrocephalus. Initially reported to work best in patients with later-onset aqueductal stenosis, ETV is now used in many centers for a wider variety of indications with varying success rates, depending on

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A re-evaluation of the Endoscopic Third Ventriculostomy Success Score: a Hydrocephalus Clinical Research Network study

Leonard H. Verhey, Abhaya V. Kulkarni, Ron W. Reeder, Jay Riva-Cambrin, Hailey Jensen, Ian F. Pollack, Brandon G. Rocque, Mandeep S. Tamber, Patrick J. McDonald, Mark D. Krieger, Jonathan A. Pindrik, Jason S. Hauptman, Samuel R. Browd, William E. Whitehead, Eric M. Jackson, John C. Wellons III, Todd C. Hankinson, Jason Chu, David D. Limbrick Jr., Jennifer M. Strahle, John R. W. Kestle, and for the Hydrocephalus Clinical Research Network

T he Endoscopic Third Ventriculostomy Success Score (ETVSS) was published in 2009 and provided a tool to predict the percentage chance of endoscopic third ventriculostomy (ETV) success using the preoperative demographic factors of age, etiology of hydrocephalus, and presence of a previous shunt. The ETVSS has been independently externally validated by others. 1 – 5 The ETVSS was developed from an international cohort of patients, the vast majority of whom had undergone ETV between 1995 and 2006. Anecdotally, there have been questions about the accuracy of

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Endoscopic third ventriculostomy in children: prospective, multicenter results from the Hydrocephalus Clinical Research Network

Abhaya V. Kulkarni, Jay Riva-Cambrin, Richard Holubkov, Samuel R. Browd, D. Douglas Cochrane, James M. Drake, David D. Limbrick, Curtis J. Rozzelle, Tamara D. Simon, Mandeep S. Tamber, John C. Wellons III, William E. Whitehead, John R. W. Kestle, and for the Hydrocephalus Clinical Research Network

E ndoscopic third ventriculostomy (ETV) is now well established as an effective treatment for many children with hydrocephalus. Small and large case series on the procedure are well documented in the medical literature, but a paucity of multicenter prospective data remains. 2 , 20 This absence of data has limited our ability to definitively answer important questions about ETV complications and efficacy. Especially lacking are accurate data regarding intraoperative events and the impact such events may have on ETV success. While the ETV Success Score

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Role of endoscopic third ventriculostomy at infected cerebrospinal fluid shunt removal

Clinical article

Tomohisa Shimizu, Mark G. Luciano, and Toru Fukuhara

interpretation of data: Fukuhara. Drafting the article: Shimizu, Fukuhara. Critically revising the article: all authors. Reviewed submitted version of manuscript: all authors. Approved the final version of the manuscript on behalf of all authors: Luciano. Statistical analysis: Fukuhara. Study supervision: Luciano. References 1 Elgamal EA : Continuous monitoring of intracranial pressure after endoscopic third ventriculostomy in the management of CSF shunt failure . Minim Invasive Neurosurg 53 : 49 – 54 , 2010 10.1055/s-0030-1249101 2 Erşahin Y , Arslan D

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Complications of endoscopic third ventriculostomy

A review

Triantafyllos Bouras and Spyros Sgouros

E ndoscopic third ventriculostomy (ETV) has been advocated as the method of choice for the treatment of obstructive hydrocephalus of certain etiologies, among which aqueductal stenosis 17 and tumors of the posterior fossa and the fourth ventricle 31 , 32 are the principal ones. Furthermore, as experience grows, various studies suggest that ETV is at least as efficient as VP shunt placement, which is the main alternative treatment, in hydrocephalus of other causes, such as meningomyelocele-related hydrocephalus, posthemorrhagic hydrocephalus

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Combined endoscopic third ventriculostomy and choroid plexus cauterization as primary treatment for infant hydrocephalus: a prospective North American series

Clinical article

Scellig S. D. Stone and Benjamin C. Warf

I n 2005, Warf first reported the technique and results of combining endoscopic third ventriculostomy (ETV) with bilateral endoscopic lateral ventricle choroid plexus cauterization (CPC) to treat hydrocephalus in infants. 13 Subsequently, the efficacy of the procedure has been demonstrated among distinct etiologies of hydrocephalus in infants, with overall long-term success of more than 60% for all patients if the prepontine cistern is not obstructed by arachnoid scarring. 14 , 16–19 , 22 , 23 With the exception of 2 studies from US institutions of ETV

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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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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