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59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

01. - 04.06.2008, Würzburg

Is endoscopic third ventriculostomy an internal shunt alone?

Meeting Abstract

  • corresponding author M. Gangemi - Department of Neurological Sciences, Section of Neurosurgery, Center of Excellence for Technological Innovation in Surgery “ITC”, “Federico II” University School of Medicine, Naples, Italy
  • F. Maiuri - Department of Neurological Sciences, Section of Neurosurgery, Center of Excellence for Technological Innovation in Surgery “ITC”, “Federico II” University School of Medicine, Naples, Italy
  • G. Colella - Department of Neurological Sciences, Section of Neurosurgery, Center of Excellence for Technological Innovation in Surgery “ITC”, “Federico II” University School of Medicine, Naples, Italy
  • F. Magro - Department of Neurological Sciences, Section of Neurosurgery, Center of Excellence for Technological Innovation in Surgery “ITC”, “Federico II” University School of Medicine, Naples, Italy
  • V. Seneca - Department of Neurological Sciences, Section of Neurosurgery, Center of Excellence for Technological Innovation in Surgery “ITC”, “Federico II” University School of Medicine, Naples, Italy

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocMO.12.09

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2008/08dgnc125.shtml

Veröffentlicht: 30. Mai 2008

© 2008 Gangemi et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective: This study was made to define the mechanism of endoscopic third ventriculostomy (ETV) in the various forms of hydrocephalus.

Methods: One hundred-sixty patients with various forms of hydrocephalus treated by ETV are reviewed. The series includes 82 cases (51.25%) of triventricular obstructive hydrocephalus (group 1), 23 (14.4%) with hydrocephalus following CSF infection or hemorrhage (group 2) and 55 (34.4%) with idiopathic normal pressure hydrocephalus (group 3). Factors which have been considered include type and etiology of the hydrocephalus, intraoperative evidence of downward and upward movement of the third ventricular floor after the stomy, patient outcome and rate of shunt-independent cases.

Results: The overall rate of successful ETV was 75.6% (121/160 shunt - free patients). The success rate was 88% (72/82) in group 1, 60.8% (14/23) in group 2 and 63.6% (35/55) in group 3. The intraoperative finding of significant movement of the third ventricular floor after the stomy was evidenced in 136/160 cases (85%) and particularly in all cases of group 1, in 10/23 (43.5%) of group 2 and in 44/55 (80%) of group 3.

Conclusions: The relatively high rate of success of ETV in various forms of hydrocephalus and the intraoperative finding of mobility of the third ventricle floor after the stomy suggest that the first mechanism of the ETV is the restoration of the pulsatility of the ventricular walls. This results in restoration of the CSF flow from the ventricular system into the subarachnoid spaces and normalization of the CSF dynamics. Accordingly, ETV is not only an internal shunt, but it primarily influences the capacity of the brain pulsatility to ensure the CSF flow.