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Endoscopic third ventriculostomy.

R F Jones1, W A Stening, M Brydon

  • 1Department of Neurosurgery, Prince of Wales Children's Hospital, Sydney, Australia.

Neurosurgery
|January 1, 1990
PubMed
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Third ventriculostomy offers a safe and effective intracranial cerebrospinal fluid diversion for hydrocephalus, reducing reliance on shunts and associated complications. This method shows promise for various hydrocephalus types, including acquired aqueductal stenosis and congenital conditions.

Area of Science:

  • Neurosurgery
  • Pediatric Neurosurgery
  • Hydrocephalus Management

Background:

  • Extracranial shunts for hydrocephalus present significant risks of malfunction and infection.
  • Previous outcomes with shunting have been disappointing in some cases.
  • Third ventriculostomy, an intracranial cerebrospinal fluid diversion, was historically underutilized.

Purpose of the Study:

  • To evaluate the efficacy and safety of third ventriculostomy for managing hydrocephalus.
  • To assess its applicability in diverse hydrocephalus etiologies.
  • To compare outcomes with traditional extracranial shunting.

Main Methods:

  • Performed third ventriculostomy in 5 patients with acquired aqueductal stenosis.
  • Expanded patient selection to 19 additional children with Arnold-Chiari malformations, congenital noncommunicating hydrocephalus, and tumors.

Related Experiment Videos

  • Monitored for shunt malfunction, infection, and significant morbidity postoperatively.

    • Main Results:

    • Successfully managed 5 patients with acquired aqueductal stenosis via third ventriculostomy with no significant morbidity.
    • Two-thirds of the 19 expanded-selection patients remain shunt-free.
    • One patient developed postoperative hemiplegia; overall morbidity remained low across the cohort.

    Conclusions:

    • Third ventriculostomy is a viable and safe alternative to extracranial shunts for selected hydrocephalus cases.
    • It effectively manages various hydrocephalus types, including congenital and acquired conditions.
    • Even in cases requiring subsequent shunting, third ventriculostomy may reduce long-term shunt dependency.