scholarly journals Natural History of Endoscopic Third Ventriculostomy in Adults: Serial Evaluation with High-Resolution CISS

2018 ◽  
Vol 39 (12) ◽  
pp. 2231-2236 ◽  
Author(s):  
M. Trelles ◽  
A.K. Ahmed ◽  
C.H. Mitchell ◽  
I. Josue-Torres ◽  
D. Rigamonti ◽  
...  
Keyword(s):  
High Resolution ◽  
Natural History ◽  
Endoscopic Third Ventriculostomy ◽  
Third Ventriculostomy ◽  
History Of ◽  
Serial Evaluation

scholarly journals Natural history of Endoscopic Third Ventriculostomy followed with high resolution MRI

2015 ◽  
Vol 12 (Suppl 1) ◽  
pp. O15
Author(s):  
Miguel Trelles ◽  
Ignacio Jusue-Torres ◽  
Charles Mitchell ◽  
Solomon David ◽  
Eric W Sankey ◽  
...  
Keyword(s):  
High Resolution ◽  
Natural History ◽  
Endoscopic Third Ventriculostomy ◽  
Third Ventriculostomy ◽  
High Resolution Mri ◽  
History Of

A lesson in history: the evolution of endoscopic third ventriculostomy

2012 ◽  
Vol 33 (2) ◽  
pp. E11 ◽  
Author(s):  
Paul J. Schmitt ◽  
John A. Jane
Keyword(s):  
Patient Selection ◽  
Endoscopic Third Ventriculostomy ◽  
Lessons Learned ◽  
New Technique ◽  
Third Ventriculostomy ◽  
Evidence Based ◽  
Success Rates ◽  
Effective Implementation ◽  
Remarkable Improvement ◽  
History Of

The history of endoscopic third ventriculostomy (ETV) demonstrates the importance of studying neurosurgery's history. A story that began with numerous technological advancements started to fizzle as neurosurgeons were stymied by problems encountered during the infancy of the technology they were still developing. The new technique, although sound in theory, failed to deliver a realistic solution for managing hydrocephalus; it lost the battle to the valved shunt. Over the last 15–20 years, a clearer understanding of pathophysiological mechanisms underlying various forms of hydrocephalus, along with effective implementation of evidence-based practice, has allowed for optimization of patient selection and a remarkable improvement in ETV success rates. Neurosurgeons would be wise to take the lessons learned in modernizing the ETV procedure and reassure themselves that these lessons do not apply to other methods that are tempting to dismiss as antiquated or archaic.

scholarly journals Dandy–Walker syndrome associated with syringomyelia in an adult: a case report and literature review

2019 ◽  
Vol 47 (4) ◽  
pp. 1771-1777
Author(s):  
Nan Zhang ◽  
Zhenyu Qi ◽  
Xuewen Zhang ◽  
Fangping Zhong ◽  
Hui Yao ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Endoscopic Third Ventriculostomy ◽  
Rare Condition ◽  
Third Ventriculostomy ◽  
Resonance Imaging ◽  
Adult Case ◽  
History Of ◽  
Memory Deterioration

Dandy–Walker syndrome associated with syringomyelia is a rare condition, with few reports of adult cases. We describe an adult case of Dandy–Walker syndrome with concomitant syringomyelia. A 33-year-old man presented with a 3-month history of walking instability, numbness in the hands, memory deterioration, and urinary incontinence. A physical examination showed a positive Romberg sign. Brain computed tomography and magnetic resonance imaging showed hydrocephalus, a cyst in the posterior fossa, absence of the cerebellar vermis, hypoplasia of the corpus callosum and cerebella, and syringomyelia. All of these symptoms were consistent with the diagnosis of Dandy–Walker syndrome. Surgery involving arachnoid adhesiolysis and endoscopic third ventriculostomy was performed. At the 6-month follow-up, the symptoms were completely relieved. Magnetic resonance imaging showed that syringomyelia was greatly reduced and the hydrocephalus remained unchanged. Dandy–Walker syndrome with concomitant syringomyelia in adults is exceedingly rare. Early diagnosis and appropriate surgical treatment of this condition should be highlighted. Combined arachnoid adhesiolysis and endoscopic third ventriculostomy may be an effective approach.

scholarly journals Isolated Spontaneous Midbrain Hemorrhage in a 14-Year-Old Boy

2017 ◽  
Vol 78 (01) ◽  
pp. e5-e8
Author(s):  
Kim-Long Nguyen ◽  
Hyunyoung Kim ◽  
Laszlo Nagy
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Vascular Malformations ◽  
Third Ventriculostomy ◽  
Bleeding Diathesis ◽  
Resonance Imaging ◽  
Hyperactivity Disorder ◽  
Migraine Headaches ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Noncontrast Computed Tomography

AbstractIsolated spontaneous midbrain hemorrhages are rare because they are usually secondary to hemorrhages from inferior structures such as the pons and cerebellum, or superior structures such as the thalamus and putamen. While the etiologies are largely unidentified, the most common ones are vascular malformations and bleeding diathesis with hypertension being relatively uncommon. We report midbrain hemorrhage in a 14-year-old boy with a long-standing history of frequent migraine headaches and attention deficit/hyperactivity disorder (ADHD). Neurologic examinations, noncontrast computed tomography (CT) scans, and magnetic resonance imaging (MRI) suggested that the lesion likely affected the dorsal part of the midbrain. The neurologic symptoms improved following endoscopic third ventriculostomy (ETV) with the placement of external ventricular drains (EVDs). In this report, anatomical correlations to the case are discussed and previous reports of midbrain hemorrhages are reviewed.

Acquired unilateral upper limb hypertrophy as a late complication of tuberculous meningitis complicated by Chiari 1 malformation and syringomyelia

2021 ◽  
Vol 14 (5) ◽  
pp. e240413
Author(s):  
Farida Essajee ◽  
Regan Solomons ◽  
Pierre Goussard ◽  
Ronald Van Toorn
Keyword(s):  
Upper Limb ◽  
Tuberculous Meningitis ◽  
Potential Benefit ◽  
Endoscopic Third Ventriculostomy ◽  
Late Complication ◽  
Rare Condition ◽  
Third Ventriculostomy ◽  
Chiari 1 Malformation ◽  
History Of

Syringomyelia associated with tuberculous meningitis (TBM) is an extremely rare condition. Only a few adult cases have been reported. A 12-year-old woman, who previously suffered TBM at the age of 6 months, presented with a long-standing history of right upper limb panhypertrophy, dissociate anaesthesia, frequent headaches, scoliosis and acquired macrocephaly. MRI demonstrated hydrocephalus, descent of the cerebral tonsils and an intramedullary syrinx extending from C2 to L1. Endoscopic third ventriculostomy (ETV) leads to reduction in the size of the syringomyelia and resolution of the thermoanaesthesia. This case highlights a very rare long-term complication associated with childhood TBM and the potential benefit offered by ETV.

scholarly journals Combined microsurgical-endoscopic paramedian supracerebellar-infratentorial approach for resection of a pineal low-grade glioma

2021 ◽  
Vol 5 (1) ◽  
pp. V9
Author(s):  
Juan M. Revuelta Barbero ◽  
Roberto M. Soriano ◽  
Rima S. Rindler ◽  
David P. Bray ◽  
Oswaldo Henriquez ◽  
...  
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Third Ventricle ◽  
Pineal Region ◽  
Third Ventriculostomy ◽  
Low Grade ◽  
Total Resection ◽  
Blurred Vision ◽  
History Of ◽  
Supracerebellar Infratentorial Approach

The authors present the case of a 20-year-old male with a history of headaches and blurred vision found to have a pineal mass and chronic hydrocephalus. The patient initially underwent an endoscopic third ventriculostomy and pineal mass biopsy that revealed a low-grade neuroepithelial neoplasm. A microsurgery-endoscope–assisted paramedian supracerebellar-infratentorial approach was chosen and a gross-total resection was achieved. The patient’s postoperative and follow-up course has been unremarkable, with early postoperative imaging demonstrating no residual tumoral mass. The operative video highlights the advantages of endoscopic visualization for deep lesions in the pineal region and posterior third ventricle. The video can be found here: https://stream.cadmore.media/r10.3171/2021.4.FOCVID2119.

Quality of life in children with hydrocephalus treated with endoscopic third ventriculostomy

2021 ◽  
pp. 1-8
Author(s):  
Ángela Ros-Sanjuán ◽  
Sara Iglesias-Moroño ◽  
Bienvenido Ros-López ◽  
Francisca Rius-Díaz ◽  
Andrea Delgado-Babiano ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Endoscopic Third Ventriculostomy ◽  
Epileptic Seizures ◽  
Third Ventriculostomy ◽  
Neurosurgical Procedures ◽  
Physical Domain ◽  
History Of ◽  
The Mean

OBJECTIVEThe objectives of this study were to determine the quality of life of a pediatric cohort with hydrocephalus treated by endoscopic third ventriculostomy (ETV), using the Hydrocephalus Outcome Questionnaire–Spanish version (HOQ-Sv), and study the clinical and radiological factors associated with a better or worse functional status.METHODSThis cross-sectional study was undertaken between September 2018 and December 2019. It comprised a series of 40 patients ranging from 5 to 18 years old with hydrocephalus treated by ETV. ETV was considered to be successful if there was no need for surgery for the treatment of hydrocephalus after a minimum follow-up of 6 months. The clinical variables included gender, age at hydrocephalus diagnosis, age at the time of ETV, age at completion of the questionnaire, etiology and type of hydrocephalus (communicating or not), prior shunt, repeat ETV, number of neurosurgical procedures, number of epileptic seizures, presenting signs, and follow-up duration until last office revision. The radiological variables were the Evans Index and the pre- and posttreatment frontooccipital horn ratio. An analysis was conducted of the association between all these variables and the various dimensions on the HOQ-Sv, completed by the parents of the patients via telephone or in the outpatient offices.RESULTSThe mean age of the children at ETV was 7 years (range 7–194 months), and on completing the questionnaire was 12 years (range 60–216 months). The mean HOQ scores were as follows: overall 0.82, physical domain 0.86, social-emotional (SE) domain 0.84, cognitive domain 0.75, and utility score 0.90. A history of epileptic crises was a predictive factor for a worse score overall and in the SE and cognitive domains. Factors related to a worse score in the physical domain were a previous shunt, the number of procedures, and the etiology and type of hydrocephalus. The mean follow-up duration from ETV to the last office visit was 5 years (64.5 months). No association was found between the degree of ventricular reduction and the quality of life.CONCLUSIONSThe factors related to a worse score in the different dimensions of the HOQ were a history of epileptic seizures, the number of procedures, communicating hydrocephalus, and having had a previous valve. No association was found between the reduction in ventricular size and the quality of life as measured on the HOQ-Sv.

Complications and subsequent removal of retained shunt hardware after endoscopic third ventriculostomy: case series

2013 ◽  
Vol 11 (6) ◽  
pp. 722-726 ◽  
Author(s):  
Jonathan Pindrik ◽  
George I. Jallo ◽  
Edward S. Ahn
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Case Series ◽  
Wound Dehiscence ◽  
Third Ventriculostomy ◽  
Subsequent Removal ◽  
Shunt System ◽  
Shunt Valve ◽  
Shunt Insertion ◽  
History Of ◽  
Shunt Removal

This case series highlights multiple complications and subsequent removal of retained shunt hardware in pediatric patients after successful endoscopic third ventriculostomy (ETV). Removal or retention of existing shunt hardware following ETV represents an important dilemma. Prior studies have reported infections and organ perforation related to nonfunctioning shunts but none in the context of successful ETV. Data obtained in 3 children with hydrocephalus treated at the authors' institution were retrospectively reviewed after the patients experienced complications due to retained shunt hardware following ETV. Etiologies of hydrocephalus included tectal glioma and intraventricular hemorrhage. All 3 patients had a history of multiple shunt revisions and underwent urgent ETV in the setting of a shunt malfunction. In each case, the entire shunt system was left in situ, but it became the source of subsequent complications. Two of the 3 patients presented with the shunt infected by gram-negative bacilli 10 days and 4.5 months postoperatively, respectively. The remaining patient experienced wound dehiscence over the shunt valve 4.5 months after ETV. In all patients, the complications were managed successfully by removing the shunt hardware. None of the patients required repeat shunt insertion from the time of removal throughout the follow-up period (mean 24 months, range 9–36 months). During the study period, a total of 6 patients with indwelling shunt hardware underwent ETV with the expectation of being shunt independent. Among these 6 patients, 3 experienced no complications from the retained hardware whereas 3 patients (50%) ultimately experienced adverse consequences related to retained hardware. This case series illustrates complications involving retained shunt hardware after successful ETV. These examples support consideration of shunt removal at the time of ETV in the appropriate context.

Relating the appearances of thyroiditis on high resolution ultrasound to the natural history of the condition

2013 ◽  
Vol 68 ◽  
pp. S4
Author(s):  
Hyeladzira Thahal ◽  
Jonathan Rodrigues ◽  
Cook John-Luke
Keyword(s):  
High Resolution ◽  
Natural History ◽  
History Of

Pediatric endoscopic third ventriculostomy: a population-based study

2014 ◽  
Vol 14 (5) ◽  
pp. 455-464 ◽  
Author(s):  
Sandi Lam ◽  
Dominic Harris ◽  
Brandon G. Rocque ◽  
Sandra A. Ham
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Aqueductal Stenosis ◽  
Population Based ◽  
Third Ventriculostomy ◽  
Administrative Claims ◽  
Risk Of Failure ◽  
Ventriculoperitoneal Shunting ◽  
Shunt Procedure ◽  
History Of ◽  
The Mean

Object Endoscopic third ventriculostomy (ETV) is an alternative to ventriculoperitoneal shunting for hydrocephalus treatment. Choice of treatment options raises questions about which patients are likely to benefit from ETV. The authors performed a population-based analysis using an administrative claims database, examining current practice and outcomes for pediatric patients in the US. Methods The authors queried the MarketScan (Truven Health Analytics) database for Current Procedural Terminology codes corresponding to ETV and ventriculoperitoneal shunting from 2003 to 2011; they included patients 19 years or younger and extracted data from initial and subsequent hospitalizations. Hydrocephalus etiology was classified with ICD-9-CM coding. ETV failure was defined as any subsequent ETV or shunt procedure. Results Five hundred one patients underwent ETV. Of these, 46% were female. The mean age was 8.7 ± 6.4 years (± SD). The mean follow-up was 1.9 ± 1.8 years. Etiology of hydrocephalus was primarily tumor (41.7%) and congenital/aqueductal stenosis (24.4%). ETV was successful in 354 patients (71%). The mean time to failure was 109.9 ± 233 days. Of the 147 patients with ETV failure, 35 (24%) underwent repeat ETV and 112 (76%) had shunt placement. Patients in age groups 0 to < 6 months and 6 months to < 1 year had a significantly higher rate of ETV failure than those 10–19 years (HR 2.9, p = 0.05; and HR 2.3, p = 0.001, respectively). History of prior shunt was associated with higher risk of failure (HR 2.5, p < 0.001). There were no significant associations between hydrocephalus etiology and risk of failure. A second wave of failures occurred at 2.5–3.5 years postoperative in tumor and congenital/aqueductal stenosis patients; this was not observed in other etiology groups. Conclusions This study represents a cross-section of nationwide ETV practice over 9 years. ETV success was more likely among children 1 year and older and those with no history of prior shunt.

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