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Related Experiment Videos

Third ventriculostomy: post-operative ventricular size and outcome

T H Schwartz1, S S Yoon, F W Cutruzzola

  • 1Department of Neurological Surgery, Neurological Institute of New York, USA.

Minimally Invasive Neurosurgery : MIN
|December 1, 1996
PubMed
Summary

Third ventriculostomy success is reliably indicated by a 15% decrease in third ventricular size, not lateral ventricles. This change is evident as early as one month post-operation, reflecting clinical outcomes.

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Area of Science:

  • Neurosurgery
  • Radiology
  • Hydrocephalus Research

Background:

  • Third ventriculostomy is a neurosurgical procedure to treat hydrocephalus.
  • Assessing the functional outcome of third ventriculostomy often relies on ventricular size changes.
  • Minimal reduction in ventricular size post-procedure can complicate outcome assessment.

Purpose of the Study:

  • To determine if ventricular size changes reliably indicate a functioning third ventriculostomy.
  • To identify which ventricle's size change is a more sensitive indicator of surgical success.
  • To correlate radiographic changes with clinical outcomes in patients undergoing third ventriculostomy.

Main Methods:

  • Comparison of pre-operative and serial post-operative axial CT/MRI scans in 27 patients.

Related Experiment Videos

  • Measurement of lateral and third ventricular diameters before and after third ventriculostomy.
  • Analysis of ventricular size changes in relation to clinical improvement and specific etiological factors.

    • Main Results:

    • A significant decrease in third ventricular size (-30%) was observed in improved patients versus an increase (+13%) in unimproved patients (p < 0.00001).
    • Lateral ventricular size also changed (-23% in improved, +5% in unimproved, p < 0.005), but less reliably than the third ventricle.
    • A minimum 15% decrease in third ventricular diameter indicated success and was observed in all improved cases by one month post-operatively.

    Conclusions:

    • Third ventricular diameter reduction is a more reliable indicator of third ventriculostomy success than lateral ventricular changes.
    • Ventricular diameter changes, particularly in the third ventricle, can predict clinical outcomes as early as one month post-surgery.
    • Factors such as age, NPH symptoms, prior shunting, and meningitis history are associated with third ventriculostomy failure.