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KMID : 0857020020170010093
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Kosin Medical Journal
2002 Volume.17 No. 1 p.93 ~ p.99
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Endoscopic Third Ventriculostomy in the Management of Hydrocephalus
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Jeon Byung-Chan
Kim Do-Heon
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Abstract
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Background : Owing to the development of endoscopic equipment, endoscopic 3rd ventriculostomy (ETV) is commonly used in the treatment of hydrocephalus substituting shunt operation. ETV is the preferred treatment of aqueductal stenosis or 4th ventricle outlet obstruction. Recently, the role of ETV is expanded to selected cases of communicating hydrocephalus. We elucidated the effectiveness of ETV in hydrocephalus with our experience.
Methods : Twelve endoscopic 3rd ventriculosomies were done between February 1999 and February 2001. These included 8 non-communicating hydrocephalus and 4 communicating hydrocephalus Non-communicating hydrocephalus were caused by four pineal gland tumors, one invasive pituitary adenoma, one spontaneous cerebellar hemorrhage, and two cerebellar tumors. Communicating hydrocephalus were caused by two subarachnoid hemorrhages, one meningitis, and one acute subdural hematoma. Mean follow-up period was 11.5 months.
Results : Nine of 12 patients achieved clinical success Seven patients showed clinical improvement among eight non-communicating hydrocephalus. Two of four communicating hydrocephalus patients improved. A case of meningitis and two cases of transient fever due to hypothalamic injury were observed as complications.
Conclusion : ETV can be suggested in the treatment of selected cases of communicating hydrocephalus as well as non-communicating hydrocephalus replacing the shunt operation with high morbidities and reoperation rates. Reliable clinical tests that can predict whether ETV will be successful are necessary.
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KEYWORD
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Endoscopic Third Ventriculostomy, Hydrocephalus
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