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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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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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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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Theodore H. Schwartz, Brian Ho, Charles J. Prestigiacomo, Jeffrey N. Bruce, Neil A. Feldstein, and Robert R. Goodman

R ecent advances in endoscopic technology have led to a rise in the performance of third ventriculostomy for noncommunicating hydrocephalus. Although this technique avoids the risks of infection, malfunction, and overfunction associated with the placement of a mechanical shunt, its reliance on the reabsorptive capacity of the arachnoid granulations often translates into a minimal or unappreciable change in ventricular size. This may be true even in patients who experience symptomatic relief following successful surgery. Various invasive or costly techniques have

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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

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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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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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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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