Articles: third-ventricle-surgery.
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The aim of this study is to retrospectively evaluate a series of consecutive patients affected by post-hemorrhagic hydrocephalus in prematurity, treated with an implant of an Ommaya reservoir followed by ventriculo-peritoneal (VP) shunt and/or endoscopic third ventriculostomy (ETV) to evaluate the safety and efficacy of these treatment options in the management of the condition. ⋯ The combination of Ommaya reservoir, VP shunt, and the aggressive use of ETV as a primary treatment or as an alternative to shunt revision allowed for a significant reduction of shunt dependency in a traditionally shunt-dependent population. Further studies are warranted to optimise the algorithm of treatment in these patients.
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In recent years, ETV has been found to be effective in patients with TBMH; however, its precise selection criteria are yet to be established. We carried out this study to identify the factors affecting the outcome of ETV in TBMH. ⋯ Endoscopic third ventriculostomy is likely to fail in the presence of advanced clinical grade, extra-CNS tuberculosis, dense adhesions in prepontine cisterns, and an unidentifiable third ventricular floor anatomy. Tuberculoma in the brain in cases of TBMH may be associated with a successful ETV.
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Review Comparative Study
Endoscopic versus microsurgical resection of third ventricle colloid cysts.
Endoscopic resection of colloid cysts has been performed as an alternative to microsurgical resection and stereotactic aspiration since 1982. To date, there are limited published studies comparing these procedures. In this study, we present the largest series of endoscopic resections published to date and compare outcomes to a cohort of microsurgical resections performed at the same institution. ⋯ Endoscopic resection of colloid cysts can be performed with significantly lower risk of complication than microsurgical resection and with equivalent surgical success. Operative time and length of hospital stay are both significantly reduced with endoscopic resection.
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Comparative Study
Treatment options for third ventricular colloid cysts: comparison of open microsurgical versus endoscopic resection.
We retrospectively reviewed our experience treating third ventricular colloid cysts to compare the efficacy of endoscopic and transcallosal approaches. ⋯ Compared with transcallosal craniotomy, neuroendoscopy is a safe and effective approach for removal of colloid cysts in the third ventricle. The endoscope can be considered a first-line treatment for these lesions, with the understanding that a small number of these patients may need an open craniotomy to remove residual cysts.
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This study was made to define the mechanism of endoscopic third ventriculostomy (ETV) in the various forms of hydrocephalus. ⋯ The relatively high rate of success of ETV in various forms of hydrocephalus and the intraoperative finding of mobility of the third ventricle floor after the stomy suggest that the first mechanism of the ETV is the restoration of pulsatility of the ventricular walls. This results in restoration of the CSF flow from the ventricular system into the subarachnoid spaces and normalization of the CSF dynamics. Accordingly, ETV is not only an internal shunt, but it primarily influences the capacity of the brain pulsatility to ensure CSF flow.