EFFICACY OF ENDOSCOPIC THIRD VENTRICULOSTOMY IN NONCOMMUNICATING HYDROCEPHALUS

Authors

  • Mian Iftikhar ul Haq
  • Shahbaz Ali Khan
  • Riaz A Raja
  • Ehtisham Ahmed

Abstract

Background: Hydrocephalus is common problem requiring either extra-cranial (shunts) or intracranial (ventriculostomy) diversion of cerebrospinal fluid. Endoscopic third ventriculostomy obviatesall the complications of shunts and has been accepted as the procedure of choice for the treatment ofobstructed hydrocephalus in adults and children because of the minimally invasive nature. This studywas conducted to determine the efficacy of endoscopic third ventriculostomy in the treatment of noncommunicating hydrocephalus. Methods: This cross sectional descriptive study was done inneurosurgery department of Hayatabad Medical Complex, Peshawar, from 2nd February 2011 to 1stmarch 2012. A total of 171 patients with non-communicating hydrocephalous, irrespective of genderdiscrimination and Glasgow coma scale score of 10 and above were included in this study. Patientsbelow one year of age, with lesion in the floor of the third ventricle or near basilar artery, andhydrocephalus with infected CSF or haemorrhage were excluded. Hydrocephalous was diagnosed onCT-scan brain. All the patients were followed up till 72 hours post-operatively for the determination ofeffectiveness in terms of improvement in Glasgow coma scale by at least 2 points. All the abovementioned information including name, age, gender and address were recorded in a predesignedproforma. The data was analysed using SPSS-17. Frequency and percentage was calculated forcategorical variables. Mean±SD was calculated for age. Results: A total of 171 patients with noncommunicating hydrocephalous were included in the study. Out of 171 patients, there were 104(60.8%) males and 67 (39.2%) females. Age ranged from 1–70 years with majority of the patients wasbelow 10 years of age. Majority of the patients had hydrocephalus due to tuberculous meningitis 39.2%of the whole. In 134 (78.4%) patients the procedure was effective. Procedure was more effective inhydrocephalus due to space occupying lesion. Conclusion: Endoscopic third ventriculostomy is a veryeffective procedure for the treatment of non-communicating hydrocephalus.Keywords: Endoscopic third ventriculostomy, non-communicating hydrocephalus, effectiveness, shunt

References

Woodworth GF, See A, Bettegowda C, Batra S, Jallo GI,

Rigamonti D. Predictors of surgery-free outcome in adult

endoscopic third ventriculostomy. World Neurosurg

;78:312–7.

Hailong F, Guagfu H, Haibin T, Hong P, Yong C, Weidong L, et

al. Endoscopic third ventriculostomy in the management of

communicating hydrocephalous, a preliminary study . J

Neurosurg 2008;109:923–30.

Baykan N, Isbir O, Gerçek A, Dagçnar A, Ozek MM. Ten years

of experience with pediatric neuroendoscopicthird

ventriculostomy: Features and perioperative complications of 210

cases. J Neuroserg Anesthesiol 2005;17:33–7.

Kulkarni AV, Hui S, Shams I, Donnelly R. Quality of life in

obstructive hydrocephalus: endoscopic third ventriculostomy

compared to cerebrospinal fluid shunt. Childs Nerv Syst

;26:75–9.

Aquilina K, Pople IK, Sacree J, Carter MR, Edwards RJ. The

constant flow ventricular infusion test: a simple and useful study

in the diagnosis of third ventriculostomy failure. J Neurosurg

;116:445–52.

Yadav YR, Parihar V, Pande S, Namdev H, Agarwal M.

Endoscopic third ventriculostomy. J Neurosci Rural Pract

;3:163–73.

J Ayub Med Coll Abbottabad 2012;24(2)

http://www.ayubmed.edu.pk/JAMC/24-2/Iftikhar.pdf

Moorthy RK, Rajshekhar V. Endoscopic third ventriculostomy

for hydrocephalus: a review of indications, outcomes, and

complications. Neurol India 2011;59:848–54.

Tubbs RS, Hattab EM, Loukas M, Chern JJ, Wellons M,

Wellons JC, et al. Histological analysis of the third ventricle floor

in hydrocephalic and nonhydrocephalic brains: application to

neuroendocrine complications following third ventriculostomy

procedures. J Neurosurg Pediatr 2012;9:178–81.

Durnford AJ, Kirkham FJ, Mathad N, Sparrow OC. Endoscopic

third ventriculostomy in the treatment of childhood

hydrocephalus: validation of a success score that predicts longterm outcome. J Neurosurg Pediatr 2011;8:489–93.

Dusick JR, Arthur DM, Berqsneider M. Success and

complication rates for adult hydrocephalus: a series of 108

patients. Surg neuol 2008;69(1):5–15.

Navarro R, Parra GR, Aoron J, Olavarria G, John A, Tomita T.

endoscopic third ventriculostomy in children early and late

complications and their avoidance. Child,s nervous

system.2007;22(5):506–13.

Brohi SR, Brohi AR, Sidiqui MA, Mughal SA, Saeed S.

Outcome of endoscopic third ventriculostomy in hydrocephalus.

J of surg pak 2010;15(1):25–8.

Sufianov AA, Sufianova GZ, Lakimov IA. Endoscopic third

ventriculostomy in patients younger than two years: outcome

analysis of 41 cases. J Neurosurg pediatr 2010;5:392–401.

Buxton N, Turners B, Ramli N, Vloeberghs M. changes in

ventricular size with neroendoscopic third ventriculostomy: A

blinded study. J Neurol Neurosurge Psychiatory 2002;72:385–7.

Gangemi M, Mascari C, Maiuri F, Godano U, DONATI P,

Longatti PL. Long term outcome of endoscopic third

ventriculostomy in obstructive hydrocephalus. Minim invasive

Neurosurge 2007;50:265–9.

Hellwig D, Grotenhuis JA, Tirakotai W, Riegel T, Schulte DM,

Bauer BL, Bertalanffy H. Endoscopic third ventriculostomy for

obstructive hydrocephalus. Neurosurg Rev 2005;28:1–34

Jinkenson MD, Havhurst C, Jumaily MA, Kandasamy J, Clark S,

Malucci CL. The role of endoscopic third ventriculostomy in

adult patients with obstructive hydrocephalus. J Neurosurg

;110:861–6.

Sacko O, Boetto S, Cances VL, Dupuy M, Roux FE. Endoscopic

third ventriculostomy, outcome analysis in 368 procedures. J

Neurosurg Pediatr 2010;5:68–74.

Published

2012-06-01

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