gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Value of endoscopic third ventriculostomy for shunt malfunction

Wert der endoskopischen Dritt-Ventrikulostomie bei Shuntdysfunktion

Meeting Abstract

  • corresponding author J. Baldauf - Ernst-Moritz-Arndt Universität Greifswald, Klinik für Neurochirurgie
  • J. Oertel - Klinikum Hannover Nordstadt, Klinik für Neurochirurgie
  • M. R. Gaab - Klinikum Hannover Nordstadt, Klinik für Neurochirurgie
  • H. W. S. Schroeder - Ernst-Moritz-Arndt Universität Greifswald, Klinik für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocDO.03.08

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2007/07dgnc026.shtml

Published: April 11, 2007

© 2007 Baldauf et al.
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Outline

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Objective: Endoscopic third ventriculostomy (ETV) for the treatment of hydrocephalus of different etiologies has been well established over the last decade. The purpose of this study was to analyze the value of ETV for shunt malfunction or infection.

Methods: ETV was performed in 234 patients at our department between 1993 and 2005. We reviewed the data of all patients with previous shunts who underwent ETV instead of shunt revision. The procedure was successful when subsequent shunt implantation was avoided.

Results: The prospectively collected database recognized 27 patients (16 male, 11 female). Average age was 26 years (ranging from six months to 69 years). The patients had a history of shunts before ETV ranging from six months to 42 years (mean 14 years). Primary cause of hydrocephalus was idiopathic aqueduct stenosis (9), congenital anomaly (8), posthemorrhagic (4), postmeningtic (3), posttraumatic (1) and tumor-related (2). Ten patients underwent ETV because of shunt infection and 17 due to shunt malfunction. ETV was successful in 18 patients (Re-ETV: 2) with a mean follow up of 33 months. The procedure failed in nine patients (Re-ETV: 4). Nine patients required subsequent shunting, eight after a mean period of 1.7 months, two had a primary cause of postmeningitic hydrocephalus and four present a shunt infection. One patient received a shunt after 63 months because of an uncertain development of the hydrocephalus. All children (3), less than two years old, had an unsuccessful ETV. We found good results for patients with a primary non-communicating hydrocephalus (16). Shunt infection did not minimize the success of ETV in 5 cases.

Conclusions: ETV is a reliable technique to be used instead of shunt revision in patients with shunt malfunction. Patients with non-communicating hydrocephalus benefit more frequently from the procedure. Shunt infection was not a contraindication to the procedure (50% success).