Rare Diseases Symptoms Automatic Extraction
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Is there an indication for ETV in young infants in aetiologies other than isolated aqueduct stenosis?
[hydrocephalus with stenosis of the aqueduct of sylvius]
The
objective
was
to
determine
whether
endoscopic
third
ventriculostomy
(
ETV
)
has
a
role
in
the
management
of
obstructive
hydrocephalus
in
aetiologies
other
than
idiopathic
aqueduct
stenosis
(
AS
)
in
infants
.
In
addition
to
reviewing
the
literature
,
we
performed
a
retrospective
analysis
of
our
endoscopy
database
,
which
was
established
in
1998
,
and
analysed
the
outcome
results
of
all
cases
of
ETV
in
those
under
1
year
of
age
which
were
performed
between
1998
and
2003
.
We
included
cases
of
idiopathic
AS
in
the
outcome
analysis
as
a
benchmark
of
successful
outcome
.
Successful
outcome
was
assessed
by
resolution
of
the
presenting
clinical
features
and
shunt
freedom
.
Aetiologies
that
were
identified
included
,
in
addition
to
idiopathic
AS
,
suprasellar
arachnoid
cysts
,
AS
in
association
with
post-haemorrhagic
hydrocephalus
(
PHH
)
,
post-infectious
hydrocephalus
(
PIH
)
,
tumour-related
hydrocephalus
and
a
heterogenous
group
including
Dandy-
Walker
malformation
and
other
developmental
anomalies
.
Suprasellar
arachnoid
cysts
had
a
100
%
outcome
success
.
Idiopathic
AS
had
a
50
%
outcome
success
and
the
successful
outcome
of
PHH
cases
was
poor
at
18
%
.
A
statistical
analysis
revealed
no
effect
of
age
at
the
time
of
ETV
on
the
outcome
in
the
aetiological
groups
.
The
definitive
initial
neurosurgical
management
of
suprasellar
arachnoid
cysts
causing
significant
hydrocephalus
is
ETV
,
whereas
that
for
PHH
and
PIH
is
probably
that
of
a
ventriculo-peritoneal
shunt
placement
.
We
speculate
that
there
may
be
a
sub-group
of
AS
cases
,
termed
pure
or
idiopathic
AS
,
which
have
a
higher
rate
of
successful
outcome
that
may
be
durable
from
a
younger
age
.
The
role
of
repeat
ETV
is
controversial
.
Diseases
Validation
Diseases presenting
"definitive initial neurosurgical management"
symptom
hydrocephalus with stenosis of the aqueduct of sylvius
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