Acute negative-pressure hydrocephalus: Management algorithm and value of early endoscopic ventriculostomy

Area of Science:

• Neurosurgery
• Neurology
• Medical Technology

Background:

• Acute negative-pressure hydrocephalus is a rare but severe condition with significant morbidity and mortality.
• Early diagnosis and effective treatment are crucial for improving patient outcomes.

Purpose of the Study:

• To propose a management algorithm for acute negative-pressure hydrocephalus.
• To evaluate the efficacy of endoscopic third ventriculostomy as an initial therapeutic option.

Main Methods:

• An observational retrospective study was conducted.
• Five patients diagnosed with acute negative-pressure hydrocephalus were included.
• A management algorithm was applied to four patients, focusing on early diagnosis and endoscopic intervention.

Main Results:

• The management algorithm was applied in 80% of cases, leading to early diagnosis and endoscopic third ventriculostomy.
• Endoscopic third ventriculostomy was successful in 50% of patients, with the remaining requiring permanent shunts.
• Overall, 80% of patients experienced good outcomes, with one mortality due to systemic infection.

Conclusions:

• Early identification of negative-pressure hydrocephalus is vital to mitigate complications.
• Implementing a specific management algorithm and early endoscopic third ventriculostomy can lead to improved patient outcomes.