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Endoscopic third ventriculostomy for idiopathic aqueductal stenosis.
[hydrocephalus with stenosis of the aqueduct of sylvius]
Idiopathic
aqueductal
stenosis
is
a
cause
of
noncommunicating
hydrocephalus
,
which
actual
treatment
with
endoscopic
third
ventriculostomy
(
ETV
)
could
assess
without
any
interference
with
the
etiology
.
The
results
of
ETV
in
this
indication
therefore
could
be
interpreted
as
the
result
of
the
surgical
procedure
alone
,
without
any
additional
factors
related
to
the
etiology
of
the
cerebrospinal
fluid
pathway
obstruction
,
such
as
hemorrhage
,
infection
,
brain
malformations
,
or
brain
tumors
or
cysts
.
After
a
brief
description
of
pathogenesis
of
hydrocephalus
in
aqueductal
stenosis
,
the
authors
review
the
literature
for
studies
on
ETV
,
extrapolating
patients
with
idiopathic
aqueductal
stenosis
in
infancy
,
childhood
,
and
adulthood
.
Differences
in
outcome
between
patients
treated
with
ETV
and
patients
treated
with
ventriculoperitoneal
shunt
(
VPS
)
are
also
reviewed
.
The
overall
success
rates
of
ETV
range
between
23
%
to
94
%
,
with
a
mean
of
68
%
;
when
only
patients
affected
by
obstructive
triventricular
hydrocephalus
secondary
to
aqueductal
stenosis
are
considered
,
the
success
rate
is
actually
quite
homogeneous
and
stable
,
being
above
60
%
at
any
age
,
even
if
a
trend
in
lower
success
rate
in
very
young
infants
(
younger
than
6
months
of
age
)
is
noticeable
.
The
few
reports
on
intellectual
outcome
failed
to
demonstrate
differences
between
ETV
and
VPS
.
Several
issues
,
such
as
the
cause
of
failures
in
well-selected
patients
,
long
-term
outcome
in
infants
treated
with
ETV
,
effects
of
persistent
ventriculomegaly
on
neuropsychological
developmental
,
remain
unanswered
.
Larger
and
more
detailed
studies
are
needed
.
Diseases
Validation
Diseases presenting
"intellectual outcome"
symptom
hydrocephalus with stenosis of the aqueduct of sylvius
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