Experience with Lumbar Puncture Following Endoscopic Third Ventriculostomy for Obstructive Hydrocephalus

Area of Science:

• Neurosurgery
• Neurology
• Pediatric Neurosurgery

Background:

• Intracranial pressure (ICP) elevation post-endoscopic third ventriculostomy (ETV) is not fully understood.
• Obstructive hydrocephalus management requires effective ICP control.

Purpose of the Study:

• To investigate the impact of lumbar puncture (LP) on outcomes following ETV for obstructive hydrocephalus.
• To evaluate the efficacy of LP in managing postoperative ICP.

Main Methods:

• Retrospective analysis of 145 patients with obstructive hydrocephalus undergoing ETV (2009-2014).
• All patients received LP on postoperative days 1 and 3.
• Extended LP protocol for patients with persistent high ICP.

Main Results:

• 106 patients achieved normal ICP and symptom relief post-ETV and initial LP.
• 39 patients required extended LP, consistently normalizing ICP.
• Peak ICP was observed on postoperative day 3 for pediatric patients and day 5 for adult patients.

Conclusions:

• Postoperative lumbar puncture plays a significant role in successful ETV outcomes.
• LP facilitates rapid ICP normalization, symptom alleviation, and complication prevention in obstructive hydrocephalus patients.
• LP is a valuable adjunct to ETV for managing symptomatic hydrocephalus.