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[Endoscopic ventriculostomy of the third ventricle in infants of less than 2 years of age].
[hydrocephalus with stenosis of the aqueduct of sylvius]
The
efficiency
of
endoscopic
ventriculostomy
(
EVS
)
of
the
third
ventricle
is
noticeably
lower
in
small
children
than
in
adults
and
many
surgeons
prefer
to
shunt
them
despite
the
fact
that
revision
has
to
be
resorted
to
in
half
of
the
cases
.
Recent
reports
on
the
successful
use
of
EVS
in
infants
under
2
years
of
age
have
made
the
authors
to
revise
traditional
views
.
A
sample
of
20
babies
(
mean
age
9
.
7
+
/
-
4
.
3
months
)
with
obstructive
triventricular
hydrocephalus
(
HC
)
undergone
EVS
at
the
Academician
N
.
N
.
Burdenko
Research
Institute
of
Neurosurgery
,
Russian
Academy
of
Medical
Sciences
,
in
1999
to
2006
.
The
cause
of
HC
was
intracranial
infection
(
n
=
7
)
,
hemorrhage
(
n
=
4
)
,
aqueduct
stenosis
(
n
=
4
)
,
Galen
's
vein
aneurysms
(
GVA
)
(
n
=
3
)
,
and
posterior
third
ventricular
tumors
(
n
=
2
)
.
Postoperative
follow-ups
averaged
15
months
.
There
were
no
deaths
;
overall
morbidity
was
10
%
.
By
and
large
,
the
efficiency
of
EVS
was
47
%
.
At
the
same
time
,
the
best
results
were
observed
in
babies
with
GVA
(
100
%
)
and
aqueduct
stenosis
(
75
%
)
.
The
results
were
significantly
worse
in
patients
with
the
postinflammatory
(
33
%
)
and
posthemorrhagic
(
0
%
)
etiology
of
HC
.
In
addition
to
the
etiology
,
the
efficiency
of
EVS
correlated
with
factors
,
such
as
prolapse
of
the
third
ventricular
floor
into
the
interpeduncular
cistern
,
the
thickened
and
rigid
floor
of
the
third
ventricle
,
and
an
analysis
excluding
3
babies
with
GVA
established
a
direct
correlation
between
the
dysfunction
of
EVS
and
the
early
manifestation
of
HC
.
Postoperative
clinical
improvement
was
attended
by
decreases
in
the
anterior
-
posterior
horn
ratio
in
all
cases
and
in
the
sizes
of
the
third
ventricle
.
Diseases
Validation
Diseases presenting
"the thickened and rigid floor of the third ventricle"
symptom
hydrocephalus with stenosis of the aqueduct of sylvius
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