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Post-traumatic hydrocephalus is a contraindication for endoscopic third-ventriculostomy: isn't it?
Pasquale De Bonis1, Gianpiero Tamburrini, Annunziato Mangiola
1Institute of Neurosurgery, Catholic University School of Medicine, Largo F. Vito 1, 00168 Rome, Italy. debonisvox@gmail.com
Clinical Neurology and Neurosurgery
|August 29, 2012
Summary
Endoscopic third-ventriculostomy (ETV) may be a viable treatment for post-traumatic hydrocephalus (PTH). This review suggests ETV is safe and effective, particularly for patients with elevated intracranial pressure.
Area of Science:
- Neurosurgery
- Neurology
- Medical Technology
Background:
- Post-traumatic hydrocephalus (PTH) is often considered a contraindication for endoscopic third-ventriculostomy (ETV).
- Limited evidence exists regarding the efficacy and safety of ETV for PTH.
Purpose of the Study:
- To evaluate the current evidence supporting the use of ETV for post-traumatic hydrocephalus.
- To assess the safety and effectiveness of ETV in treating PTH.
Main Methods:
- A systematic review of clinical articles published in the last ten years was conducted.
- PubMed searches identified studies on post-traumatic hydrocephalus and endoscopic third-ventriculostomy.
- Laboratory investigations were excluded.
Main Results:
- Five articles involving 15 patients with PTH treated with ETV were analyzed.
- All patients had communicating hydrocephalus; no surgical complications were reported.
- Thirteen of 14 patients (93%) showed clinical improvement after ETV, especially those with elevated ICP.
Conclusions:
- Current evidence does not support contraindicating ETV for post-traumatic hydrocephalus.
- ETV may be reconsidered for PTH treatment, particularly in patients with elevated ICP.
- Further multi-center prospective clinical trials are necessary.
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