gms | German Medical Science

61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

Endoscopic third ventriculostomy in patients with slit ventricle syndrome or altered anatomy of the third ventricle

Meeting Abstract

Search Medline for

  • Nikolai J. Hopf - Neurochirurgische Klinik, Katharinenhospital, Klinikum Stuttgart, Deutschland
  • Markus Bittl - Neurochirurgische Klinik, Katharinenhospital, Klinikum Stuttgart, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocP1777

DOI: 10.3205/10dgnc248, URN: urn:nbn:de:0183-10dgnc2480

Published: September 16, 2010

© 2010 Hopf et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective: Endoscopic third ventriculostomy (ETV) has become a widely accepted treatment option for obstructive hydrocephalus. In case of narrow ventricles or distorted anatomy ETV is hardly used. We present a series of ETV in patients with slit ventricles or altered third ventricle.

Methods: ETV was performed in 9 patients with slit ventricle syndrome and 5 patients with altered anatomy of the third ventricle (3 posthemorrhagic changes, 1 tumor, 1 aneurysm of the vein of Galen). Indication for ETV was shunt malfunction (9 patients), shunt infection (2 patients), and hydrocephalus (3 patients). Pediatric ventriculoscopes with an outer diameter of 3.8x4.2 mm or 2.6x4.4 mm (Wolf, Knittlingen/Germany) were used. In all procedures endoscopes were used in combination with neuronavigation (VectorVision II: Brainlab, Feldkirchen/Germany).

Results: ETV could technically be achieved in all cases without complications. Proper insertion of the endoscopes into the lateral ventricle was enabled by neuronavigation. In 5 cases, the endoscope was inserted along a ventricular catheter. ETV was successful in 8 of 9 patients with slit ventricle syndrome and 3 of 4 with altered third ventricles. The overall success rate was 78%.

Conclusions: ETV is technically possible and successful even in narrow ventricles and patients with altered anatomy of the third ventricle. Neuronavigation should be used to safely insert the endoscope.