Abstract | OBJECT: METHODS: A retrospective analysis of clinical notes, operation records, and pre- and postventriculostomy neuroimaging data was performed to determine the success or failure and complications of ETV and ETB in 42 patients presenting with tumor-induced obstructive hydrocephalus. Patient data were derived from an endoscopy database initiated in 1998. The study population included 21 female and 21 male patients (mean age 37 years, range 5-77 years). All 42 patients underwent an ETV; 33 of the 42 underwent an ETV and an ETB (single-trajectory). One patient was excluded from the follow-up analysis due to rapid deterioration of his condition from tumor progression. The duration of follow up ranged from 3 to 84 months (mean 32 months). At the last follow up, 11 patients with ETVs had undergone shunt placement and two patients had undergone repeated ETVs, giving a long-term success rate of 68% (28 of 41 cases) for single ETV as a treatment for hydrocephalus at presentation. Statistical analysis revealed no significant relationship (p > 0.92) between tumor location and ETV success or failure. The mean time to ETV failure was 32 weeks. Histological examination of biopsy specimens was non-diagnostic in eight (24%) of the 33 cases in which ETB was performed. Seven of these cases involved pineal region tumors and one involved a tectal plate tumor. There was no death or major morbidity associated with ETV and ETB in this series. CONCLUSIONS:
Endoscopic third ventriculostomy is a safe and durable means of controlling hydrocephalus in tumor cases. Its success rate is high--comparable to that reported in aqueduct stenosis cases. Although ETB is probably not as accurate for diagnosis as biopsy with frame-based stereotactic guidance, it is associated with a lower mortality rate and, in the correct clinical setting, may be justifiably attempted as an initial biopsy procedure at the same time as ETV via a single-trajectory approach.
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Authors | Donncha F O'Brien, Caroline Hayhurst, Barry Pizer, Conor L Mallucci |
Journal | Journal of neurosurgery
(J Neurosurg)
Vol. 105
Issue 3 Suppl
Pg. 219-26
(Sep 2006)
ISSN: 0022-3085 [Print] United States |
PMID | 16970236
(Publication Type: Case Reports, Journal Article)
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Topics |
- Adolescent
- Adult
- Aged
- Biopsy
- Brain Neoplasms
(complications, pathology, therapy)
- Child
- Child, Preschool
- Female
- Humans
- Hydrocephalus
(etiology, surgery)
- Male
- Middle Aged
- Neuroendoscopy
- Retrospective Studies
- Third Ventricle
(surgery)
- Treatment Outcome
- Ventriculostomy
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