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Henry W. S. Schroeder, Wulf-Rüdiger Niendorf, and Michael R. Gaab

achieved in cases in which the hydrocephalus was caused by tumors. Postoperative MR images or CT scans were obtained after 178 procedures. In 10 cases, the ventricles appeared larger (6%), in 100 cases smaller (56%), and in 68 cases unchanged (38%). Discussion Endoscopic third ventriculostomy has generally been accepted as the procedure of choice for the treatment of non-communicating hydrocephalus. This procedure is considered to be simple, fast, and safe. Data from several series of patients undergoing ETV have been published; 4, 12, 18, 27, 28, 40, 65, 76

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Triantafyllos Bouras and Spyros Sgouros

severe deterioration. Methods A PubMed search using the terms “neuroendoscopy AND hydrocephalus,” “endoscopic third ventriculostomy,” and “endoscopy AND hydrocephalus” recovered 34 published series of ETV cases that were included in the study. The main inclusion criterion was the existence of detailed complication reports, along with morbidity and mortality rates both on short- and long-term follow-up. All the reported complications were categorized as intraoperative incidents (hemorrhagic, neural trauma, and anesthesia-related) or immediate postoperative events

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Michael J. Fritsch, Sven Kienke, Tobias Ankermann, Maurizio Padoin, and H. Maximilian Mehdorn

T reatment of pediatric hydrocephalus is one of the most common clinical problems in neurosurgical practice. Placement of a VP shunt is still the standard for the surgical management of the disease; yet shunt infection and shunt failure are common problems. 7, 12, 14, 15 Shunt insertion during the 1st year of life has been found to be a significant predictor for future shunt failure. 20 Endoscopic third ventriculostomy presents an alternative to shunt insertion. According to published data from several groups, infants younger than 1 year of age have a

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Henry W. S. Schroeder, Rolf W. Warzok, Jamal A. Assaf, and Michael R. Gaab

W ith the increasing use of endoscopic techniques in neurosurgery, endoscopic third ventriculostomy has become a well-established procedure for the treatment of several forms of noncommunicating hydrocephalus. 1, 5, 6, 8 Third ventriculostomy is considered to be simple, fast, and safe. Complications have rarely been reported in the literature. 2–4, 7, 9, 10 We present a case in which the patient suffered a fatal subarachnoid hemorrhage (SAH) after he underwent an endoscopic third ventriculostomy. Case Report This 63-year-old man presented with hearing loss

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Ahmed M. Alkhani, Frederick A. Boop, and James T. Rutka

presenting with obstructive hydrocephalus in whom a small, tectal neoplasm is identified, cerebrospinal fluid (CSF) diversion alone suffices in treating the patient's symptoms. 18 In recent times, endoscopic third ventriculostomy has become an effective means by which aqueductal stenosis that causes hydrocephalus can be overcome without resorting to the implantation of permanent CSF shunting devices. 4, 6, 9, 10, 19 Success rates as high as 70% have been reported for long-term control of hydrocephalus after endoscopic third ventriculostomy. 4 In this report, we describe

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Steven W. Hwang, George Al-Shamy, William E. Whitehead, Daniel J. Curry, Robert Dauser, Thomas G. Luerssen, and Andrew Jea

the illustrations featured in the paper, and Lily Chun for the editorial assistance in preparing the manuscript. This manuscript was presented at the 39th Annual Meeting of the AANS/CNS Section on Pediatric Neurological Surgery held in Cleveland, Ohio, 2010. References 1 Anandh B , Madhusudan Reddy KR , Mohanty A , Umamaheswara Rao GS , Chandramouli BA : Intraoperative bradycardia and postoperative hyperkalemia in patients undergoing endoscopic third ventriculostomy . Minim Invasive Neurosurg 45 : 154 – 157 , 2002 2 Benabarre A

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Eelco W. Hoving, Mehrnoush Rahmani, Leonie I. Los, and Victor W. Renardel de Lavalette

, Messina G , Iacopino P , Al Sayyad S , : Neuroendoscopic management of hydrocephalus secondary to midline and pineal lesions . J Neurosurg Sci 49 : 97 – 106 , 2005 5 De Terson A : l'hémorrhagie dans le corps vitré au cours de l'hemorrhagie cérébrale . Clin Ophthalmol 6 : 309 – 312 , 1900 6 Feng H , Huang G , Liao X , Fu K , Tan H , Pu H , : Endoscopic third ventriculostomy in the management of obstructive hydrocephalus: an outcome analysis . J Neurosurg 100 : 626 – 633 , 2004 7 Frizzell RT , Kuhn R , Quinn C

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Brandon A. Sherrod, Rajiv R. Iyer, and John R. W. Kestle

management alone are ineffective. Endoscopic third ventriculostomy (ETV) was initially described in 1923 by William Mixter 25 as a treatment strategy for hydrocephalus and has appeal as a method to reduce the risk of introducing hardware-related infectious complications in children who need surgical treatment for hydrocephalus. Numerous studies have compared ETV and VPS in regard to efficacy and infection rates in treatment of pediatric hydrocephalus in general, with the consensus being that ETV reduces procedural infection risk, but the overall reoperation rates for

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Raphael Guzman, Arjun V. Pendharkar, Michel Zerah, and Christian Sainte-Rose

third ventricle in relation to endoscopic ventriculostomy . Clin Anat 22 : 916 – 924 , 2009 2 Bhatia R , Tahir M , Chandler CL : The management of hydrocephalus in children with posterior fossa tumours: the role of pre-resectional endoscopic third ventriculostomy . Pediatr Neurosurg 45 : 186 – 191 , 2009 3 Cinalli G , Sainte-Rose C , Chumas P , Zerah M , Brunelle F , Lot G , : Failure of third ventriculostomy in the treatment of aqueductal stenosis in children . J Neurosurg 90 : 448 – 454 , 1999 4 Cinalli G , Spennato

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Sonja Vulcu, Leonie Eickele, Giuseppe Cinalli, Wolfgang Wagner, and Joachim Oertel

T he technique of endoscopic third ventriculostomy (ETV) has been under close evaluation as a treatment option for obstructive hydrocephalus. Although early on the procedure was associated with a very high, unacceptable complication rate, 41 more recent publications have reported success rates of about 70% and low complication rates, including mortality, around 0.5%–1.0%. 9 , 13 , 20 , 31 , 35 Nowadays, ETV is accepted as the gold standard for treatment of obstructive hydrocephalus. In comparison with ventriculoperitoneal shunting, a significantly lower