Related Experiment Video
Updated: Jun 2, 2026
03:13
Endoscopic Third Ventriculostomy and Pineal Biopsy from a Single Entry Point
Published on: June 28, 2024
Endoscopic third ventriculostomy in patients with malfunctioning CSF-shunt
Armen Melikian1, Anton Korshunov
1Department of Pediatric Neurosurgery, Burdenko Neurosurgical Institute of RAMS, Moscow, Russia. armegmelikian@gmail.com
World Neurosurgery
|April 16, 2011
Summary
Endoscopic third ventriculostomy (ETV) can successfully treat obstructive hydrocephalus in previously shunted patients, with 72% becoming shunt-free. Careful patient selection is key, as formerly shunted patients face a higher risk of complications.
Area of Science:
- Neurosurgery
- Pediatric Neurosurgery
- Hydrocephalus Management
Background:
- Obstructive hydrocephalus often requires cerebrospinal fluid (CSF) shunting.
- Endoscopic third ventriculostomy (ETV) is an alternative treatment, but outcomes in previously shunted patients are debated.
- Existing bias may favor shunt revision over ETV in malfunctioning shunt cases.
Purpose of the Study:
- To evaluate the efficacy and safety of ETV as an alternative to shunt revision in patients with obstructive triventricular hydrocephalus.
- To identify factors influencing the outcome of ETV in a cohort of previously shunted patients.
Main Methods:
- A cohort of 60 patients with obstructive triventricular hydrocephalus underwent ETV.
- Patients had a median follow-up of 2 years (range 1 month-8 years).
- Preoperative data and surgical history were analyzed to determine outcome predictors using the Mann-Whitney U test.
Main Results:
- 44 out of 60 patients (72%) improved and became shunt-free after ETV.
- 16 patients required permanent shunts.
- No significant correlation was found between outcome and patient profile (e.g., hydrocephalus etiology, infection history, age, number of prior surgeries).
- Overall morbidity was 20% (12 cases), with 5% (3 cases) experiencing serious neurological deficits.
Conclusions:
- ETV is a viable option for obstructive hydrocephalus in malfunctioning shunt cases, offering a ~70% chance of becoming shunt-free with careful selection.
- Previously shunted patients undergoing ETV have a slightly increased risk of serious complications, necessitating experienced surgical judgment.
Related Concept Videos
01:26Mitral Stenosis III: Medical Management
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
01:22Aneurysm IV: Nursing Management
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...