Artikel
Hydrocephalus in infants less than six months of age: effectiveness of endoscopic third ventriculostomy
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Autoren
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R. Faggin
- Department of Pediatrics and Chair of Neurosurgery, University of Padova, Italy
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P. Drigo
- Department of Pediatrics and Chair of Neurosurgery, University of Padova, Italy
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M. Grazini
- Department of Pediatrics and Chair of Neurosurgery, University of Padova, Italy
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P. Ciccarino
- Department of Pediatrics and Chair of Neurosurgery, University of Padova, Italy
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M. Rossetto
- Department of Pediatrics and Chair of Neurosurgery, University of Padova, Italy
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D. d’Avella
- Department of Pediatrics and Chair of Neurosurgery, University of Padova, Italy
| Veröffentlicht: | 30. Mai 2008 |
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Gliederung
Text
Objective: Although endoscopic third ventriculostomy (ETV) for treatment of congenital and acquired hydrocephalus is a well established procedure, there is still a controversy regarding the higher risk of failure in younger infants versus older children after such procedure. The aim of this paper is to better define the effectiveness of third ventriculostomy for hydrocephalus in infants less than 6 months of age and to determine possible positive predictive factors.
Methods: In a series of 126 consecutive patients who underwent ETV between January 2000 and December 2002, twenty one procedures were performed on infants ranging in age from 23 to 180 days, and without a previous history of shunting. The follow-up period was 49 to 82 months.
Results: The overall success rate of ETV was 67% (14/21). All failures occurred in the early postoperative period (average 38 days, range 25 – 88 days). The success rate varied with the etiology of the patients’ hydrocephalus. The best results were obtained in patients with aqueductal stenosis, Dandy Walker malformation and myelomeningocele. The least favorable results (50% failure) occurred in infants treated for post hemorrhagic and postmeningitis hydrocephalus.
Conclusions: This study does not demonstrate a correlation between age of infants and ETV success rate. The specific etiology of hydrocephalus is the most relevant prognostic factor in infants under six months of age.
