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Long-term outcome of endoscopic third ventriculostomy in obstructive hydrocephalus.
[hydrocephalus with stenosis of the aqueduct of sylvius]
This
multicentric
study
reports
on
140
patients
who
underwent
endoscopic
third
ventriculostomy
for
obstructive
hydrocephalus
in
four
Italian
neurosurgical
centers
between
1994
and
1999
.
Its
aim
is
to
define
the
long
-term
outcome
of
these
patients
many
years
(
6
-
12
)
after
the
initial
procedure
.
The
study
includes
both
children
and
adults
;
the
etiology
of
the
hydrocephalus
was
malformative
aqueductal
stenosis
in
88
cases
(
62
.
8
%
)
,
compression
by
tumors
of
the
mesencephalic
and
pineal
regions
and
posterior
fossa
in
45
(
32
.
2
%
)
and
post-infection
aqueductal
stenosis
in
7
(
5
%
)
.
The
ETV
was
performed
by
using
the
standard
technique
.
The
overall
rate
of
good
results
(
shunt-independent
patients
with
clinical
remission
or
improvement
)
was
87
.
1
%
.
Eighteen
patients
(
12
.
9
%
)
required
a
shunt
because
of
ETV
failure
.
The
long
-term
outcome
of
ETV
in
this
study
was
not
influenced
by
the
patient
's
age
and
the
etiology
of
the
hydrocephalus
(
although
cases
secondary
to
cisternal
hemorrhage
and
infections
are
not
included
)
.
Other
series
including
cases
with
long
follow-up
are
analyzed
.
In
conclusion
,
ETV
results
in
a
high
rate
of
good
long
-term
outcome
in
patients
with
obstructive
hydrocephalus
.
Because
postoperative
failures
occur
early
,
clinical
and
radiological
control
studies
must
be
performed
particularly
in
the
first
years
after
the
neuroendoscopic
procedure
.