An operative technique combining endoscopic third ventriculostomy and long-term ICP monitoring

Neuroendoscopy has been well established in the treatment of many neurological and neurosurgical diseases. Especially its application in occlusive hydrocephalus to restore a physiological cerebrospinal fluid circulation has been extensively examined in the past. Although such procedures are believed to be safe and effective, complication as well as failure rates up to 20% have been described pointing to the importance of long-term postoperative care. Therefore, different and partly invasive procedures as ventricular drain insertions or complex cranial imaging methods have been proposed; however, associated pitfalls and restrictions often limited their prognostic value and long-term benefit. An operative technique combining endoscopic third ventriculostomy and telemetric increased intracranial pressure monitoring has now been developed to optimize the postoperative care management. The main intention is to provide sufficient brain pressure data for long-term observation and early recognition of endoscopy failures and complications. The new operative technique was applied in a series with 24 patients suffering from occlusive hydrocephalus. Surgical technique and future perspectives are presented.