medigraphic.com

2015, Number 3

<< Back Next >>

Rev Med Inst Mex Seguro Soc 2015; 53 (3)

Endoscopic third ventriculostomy for chronic communicating hydrocephalus in adults

Sandoval-Balanzario MA, Rincón-Navarro RA, Granados-López R, Santos-Franco JA

Language: Spanish
References: 20
Page: 280-285
PDF size: 86.66 Kb.


ABSTRACT

Background: Shunt devices to treat hydrocephalus are associated with a malfunction of 81 % at 12 years and 10 % of infection. The objective was to assess safeness and efficacy of endoscopic third ventriculostomy (ETV) for the treatment of chronic communicating hydrocephalus.
Methods: Eight patients with chronic communicating hydrocephalus were included in a period between September, 2012 and April, 2013. X ray computed tomography scans were performed when patients were admitted, after the surgery, and at 30, 180 and 365 days. The follow-up was of 251 days (the biggest was of 459 days). The variables included were: age, sex, etiology, time of evolution, and the total number of shunt malfunctions. Conventional technique with a 30° rigid endoscope was performed, malfunctional shunt was removed, and a tied shunt device was placed.
Results: Four males and four females, with a mean age of 42 years (27-63 years); neurocysticercosis was identified in five patients (62.5 %); the evolution rate was of 18 years (15-30 years); the hospital stay rate was of 6.5 days (3-22 days); the mean of previous shunt malfunctions was 4 (1-6). Complications: neuroinfection in one patient, malfunction in three patients. None of them died.
Conclusion: ETV is a safety procedure for treating chronic communicating hydrocephalus; it has a success rate higher than 60 %. Neurocysticercosis showed better results when previous shunt malfunctions were lower than three.


REFERENCES

  1. Zhao K, Sun H, Shan Y, Mao BY, Zhang H. Cerebrospinal fl uid absorption disorder of arachnoid villi in a canine model of hydrocephalus. Neurology India. 2010;58(3): 371-7. doi: 10.4103/0028-3886.65601.

  2. Symss N, Oi S. Theories of cerebrospinal fl uid dynamics and hydrocephalus: historical trend. J Neurosurg Pediatr. 2013;11(2):170-7. doi: 10.3171/2012.3.PEDS0934. Epub 2012 Dec 7.

  3. Bergsneider M, Miller C, Vespa PM, Hu X. Surgical management of adult hydrocephalus. Neurosurgery. 2008; 62 (Suppl 2): 643-60. discussion 659-60. doi: 10.1227/01.neu.0000316269.82467.f7.

  4. O’Brien DF, Javadpour M, Collins DR, Spennato P, Mallucci CL. Endoscopic third ventriculostomy: an outcome analysis of primary cases and procedures performed after ventriculoperitoneal shunt malfunction. J Neurosurg Pediatr. 2005;103(5 Suppl):393-400.

  5. Kestle JR, Riva-Cambrin J, Wellons JC 3rd, Kulkarni AV, Whitehead WE, Walker ML, et al. A standardized protocol to reduce cerebrospinal fl uid shunt infection: the Hydrocephalus Clinical Research Network Quality Improvement Initiative. J Neurosurg Pediatr. 2011;8(1):22-9. doi: 10.3171/2011.4.PEDS10551

  6. Neils DM, Wang H, Lin J. Endoscopic third ventriculostomy for shunt malfunction: what to do with the shunt? Surg Neurol Int. 2013;4:3. Disponible en http://www. surgicalneurologyint.com/text.asp?2013/4/1/3/1061

  7. Bouras T, Sgouros S. Complications of endoscopic third ventriculostomy: a review. J Neurosurg Pediatr. 2011;7(6):643-9. Texto libre http://thejns.org/doi/abs/ 10.3171/2011.4.PEDS10503?url_ver=Z39.88-2003 &rfr_id=ori%3Arid%3Acrossref. org&rfr_dat=cr_pub%3Dpubmed&

  8. Santamarta D, Martin-Vallejo J, Díaz-Álvarez A, Maillo A. Changes in ventricular size after endoscopic third ventriculostomy. Acta Neurochir (Wien). 2008;150(2):119-27. discussion 127. doi: 10.1007/ s00701-007-1477-6.

  9. Schroeder HW, Gaab MR. Intracranial endoscopy. Neurosurgical Focus. 1999;6(4):e1.

  10. Amini A, Schmidt RH. Endoscopic third ventriculostomy in a series of 36 adult patients. Neurosurg Focus. 2005;19(6):E9.

  11. Warf BC, Bhai S, Kulkarni AV, Mugamba J. Shunt survival after failed endoscopic treatment of hydrocephalus. J Neurosurg Pediatr. 2012;10(6):463-70. doi: 10.3171/2012.9.PEDS1236.

  12. Woodworth G, McGirt MJ, Thomas G, Williams MA, Rigamonti D. Prior CSF shunting increases the risk of endoscopic third ventriculostomy failure in the treatment of obstructive hydrocephalus in adults. Neurol Res. 2007;29(1):27-31.

  13. Kadrian D, van Gelder J, Florida D, Jones R, Vonau M, Teo C, et al. Long-term reliability of endoscopic third ventriculostomy. Neurosurgery. 2005;56(6):1271-8, discussion 1278.

  14. Gupta S, Soellinger M, Grzybowski DM, Boesiger P, Biddiscombre J, Poulikakos D, et al. Cerebrospinal fl uid dynamics in the human cranial subarachnoid space: an overlooked mediator of cerebral disease. I. Computational model. J R Soc Interface. 2010;7(49):1195-204. doi: 10.1098/rsif.2010.0033.

  15. Edsbagge M, Tisell M, Jacobson L, Wikkelso C. Spinal CSF absorption in healthy individuals. Am J Physiol Regul Integr Comp Physiol. 2004;287(6):1450-5.

  16. Johanson CE, Duncan JA 3rd, Klinge PM, Brinker T, Stopa EG, Silverberg GD. Multiplicity of cerebrospinal fl uid functions: new challenges in health and disease. Cerebrospinal Fluid Res. 2008;5:10. Disponible en http://www.cerebrospinalfl uidresearch. com/content/5/1/10.

  17. Sotelo J, Marin C. Hydrocephalus secondary to cysticercotic arachnoiditis. A long term follow-up review of 92 cases. J Neurosurg. 1987;66(5):686-9.

  18. García HH, Evans CAW, Nash TE, Takayanagui OM, White AC Jr, Botero D, et al. Current consensus guidelines for treatment of neurocysticercosis. Clin Microbiol Rev. 2002;15(4):747-56.

  19. Matushita H, Pinto FC, Cardeal DD, Texeira MJ. Hydrocephalus in neurocysticercosis. Childs Nerv Syst. 2011;27(19):1709-21. doi: 10.1007/ s00381-011-1500-3.

  20. Gangemi M, Maiuri F, Buonamassa S, Colella G, de Divitiis E. Endoscopic third ventriculostomy in idiopathic normal pressure hydrocephalus. Neurosurgery. 2004;55(1):129-34; discussion 134.




2020     |     www.medigraphic.com