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Changes in Callosal Angle After Successful Endoscopic Third Ventriculostomy Procedure in Pediatric Patients
Bahattin Tanrikulu1, M Memet Ozek
1Acibadem Mehmet Ali Aydinlar University, School of Medicine, Department of Neurosurgery, Istanbul, Turkey.
Insights
The callosal angle (CA) significantly increased after endoscopic third ventriculostomy (ETV) in pediatric hydrocephalus patients. This suggests CA is a reliable early radiological marker for ETV success.
Area of Science:
- Pediatric Neurosurgery
- Neuroradiology
- Hydrocephalus Research
Background:
- Endoscopic third ventriculostomy (ETV) is a surgical treatment for pediatric hydrocephalus.
- Assessing ETV outcomes traditionally involves various radiological parameters.
- The callosal angle (CA) is an established metric for adult normal-pressure hydrocephalus but its utility in pediatric ETV is less defined.
Purpose of the Study:
- To evaluate the reliability of the callosal angle (CA) as a radiological parameter for assessing outcomes in pediatric patients following endoscopic third ventriculostomy (ETV).
- To compare changes in CA with other ventricular parameters post-ETV in children.
Main Methods:
- A retrospective study included 47 pediatric patients who underwent successful ETV between 2011 and 2015.
- Preoperative and three-month postoperative measurements of CA, lateral ventricle frontal horn (LVFH) width, Evans' index (EI), and frontal-occipital horn ratio (FOR) were recorded.
- Paired-samples t-test was used to analyze changes in these parameters.
Main Results:
- Postoperative CA showed a significant increase (from 78.5° to 104.5°), while LVFH width, EI, and FOR decreased.
- The magnitude of change in CA after surgery was greater than changes observed in LVFH width, EI, and FOR.
- The study included 29 males and 18 females, with consistent results across the cohort.
Conclusions:
- The callosal angle (CA) demonstrated a more pronounced change after successful ETV compared to other ventricular parameters in pediatric patients.
- CA is proposed as a valuable radiological criterion for early monitoring of ETV success in children.
- This finding supports the use of CA in the routine radiological follow-up of pediatric hydrocephalus treated with ETV.
Aim:
To determine whether callosal angle (CA) measurement, a diagnostic and prognostic tool used for normal-pressure hydrocephalus in adults, is a reliable radiological parameter for evaluating endoscopic third ventriculostomy (ETV) outcomes in pediatric patients.
Material And Methods:
Forty-seven pediatric patients with hydrocephalus who underwent successful ETV in our clinic between 2011 and 2015 were included in this study. Preoperative and postoperative three-month CA, lateral ventricle frontal horn (LVFH) width, Evans' index (EI), and frontal-occipital horn ratio (FOR) parameters were recorded, with changes analyzed using a paired-samples t-test.
Results:
There were 29 male and 18 female patients included within the cohort. For mean preoperative values, LVFH width was 58.8 ± 14.9 mm, EI was 0.43 ± 0.09, FOR was 0.51 ± 0.74, and CA was 78.5° ± 36.4°. Separately, for mean postoperative values, LVFH width was 54 ± 14.2 mm, EI was 0.39 ± 0.09, FOR was 0.47 ± 0.07, and CA was 104.5° ± 32.6°. The CA was increased and the LVFH width, EI, and FOR were decreased in all patients within three months after surgery. The postoperative three-month change in CA was higher than those observed in the other parameters.
Conclusion:
Changes in CA after successful ETV were dramatically higher than those in the other ventricular parameters. For this reason, we suggest CA be used as a radiological criterion during early radiological follow-up of patients after ETV.
