gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

The course of the Cella-media-index according to Schiersmann after ETV in different causes for obstructive hydrocephalus

Meeting Abstract

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  • Y. Mondorf - Hannover
  • M.R. Gaab - Neurochirurgische Klinik, Nordstadt-Krankenhaus Hannover
  • J. Oertel - Neurochirurgische Klinik und Poliklinik, Universitätsklinikum Mainz

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocP16-03

doi: 10.3205/09dgnc424, urn:nbn:de:0183-09dgnc4243

Published: May 20, 2009

© 2009 Mondorf et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Malformations of the posterior fossa and giant aneurysms of the basilar artery can lead to chronic obstructive hydrocephalus, while intracerebral hemorrhages lead to acute hydrocephalus. Between 2003 und 2008, 33 endoscopic third-ventriculostomies were performed at our department because of the pathologies mentioned above.

Methods: 14 endoscopic third-ventriculostomies (ETVs) were performed in malformation of the posterior fossa, 17 ETVs in patients suffering from an intracerebral hemorrhage, and 2 ETVs in patients suffering from a giant aneurysm of the basilar artery. Patients’ age ranged from 1 month up to 83 years. All patients suffered from ventricular dilation and some clinical presentation of hydrocephalus preoperatively. The cella-media-index was analyzed pre- and postoperatively.

Results: All patients received an MRI or CT-scan pre- and postoperatively. Preoperatively, all patients with a malformation of the posterior fossa suffered from significant enlargement of the ventricles. Preoperatively, the cella media index according to Schiersmann was highly pathologic (<2.9) in 12 (85.7%), moderately pathologic (3.5-3.0) in 2 (14.3%), less pathologic (4.0-3.6) in 0, and normal (>4.1) in 0 patients. Postoperatively, the cella-media-index improved in 8 (57.1%), remained unchanged in 1 (7.1%), and further decreased in 5 (35.7%) patients. In the patients with intracerebral hemorrhage the cella-media-index was pathologic preoperatively in 16 patients (94%). Postoperatively, it improved in 12 (70.6%) and was normal in 4 cases (23.5%). In the two patients with giant aneurysms of the basilar artery the cella-media-index increased from 2.84 to 3.0 and from 2.73 to 3.09.

Conclusions: The course of the cella-media-index is dependent on the type of the obstructive hydrocephalus. Even though especially in the group suffering from a malformation of the posterior fossa no normal cella-media-index could be found after ETV, the clinical improvement was significant. Of the patients with intracerebellar hemorrhage and a large improvement of the cella-media-index after ETV 8 patients died. Both patients suffering from giant aneurysm had an improvement of the cella-media-index and the clinical status.