ABSTRACT
Objective: To evaluate retrospectively, a group of patients of our series, that had a failed ventriculostomy to try to determine the causes and the treatement offered to them. Material and method: 140 ETVs were performed in 132 patients; 120 of them are shunt free (90.90). Eight patients (5.71) showed closure of the ventriculostomy: in 4, it was presumed to be related to postoperative radiotherapy; 2 patients had an insufficient opening of the Lilliequist membrane and 2 showed ostoma closure of origin. In all of them a second ETV was performed, and the procedure was successful. Twelve patients (8.57) required shunt placement; 4, with a history of septated postmeningitis hydrocephalus, now only need a single ventricular catheter. Of the remaining, 3 presented with meningeal seeding from malignant tumors; 1 with racemous neurocysticerosis, 1 with multiple malformations and history meningitis; 2 with a previously unknown aresorptive component; 1 with history of post- shunt meningitis. Most patients with ETV failure developed CSF fistula. In all these cases, patency of the ostoma was confirmed during re-exploration, and consequently, a shunt was indicated. Discussion and conclusion: We consider ETV to be the standard treatment for obstructive hydrocephalus. With low morbidity in our series (4.68) and no mortality. Re-exploration and eventual re-fenestration are indicated in al cases of ETV failure, given the benefits of shunt independence.
Subject(s)
Endoscopy , Hydrocephalus , VentriculostomySubject(s)
Humans , History of Medicine , Hydrocephalus/history , Hydrocephalus/therapy , Neurology/historyABSTRACT
Los autores reportan una serie de 16 pacientes portadores de procesos expansivos del III ventrículo tratados con técnicas endoscópicas. Se discuten los procedimientos clínicos, radiológicos y quirúrgicos utilizados, la evolución y los hallazgos histológicos. Material y métodos: entre agosto de 1995 y noviembre de 1999, hemos tratados 16 pacientes con patología expansiva del tercer ventrículo, utilizando técnicas endoscópicas, el promedio de edad fue de 32,63 años (rango entre 1 mes y 76 años), en diez pacientes se realizó tercer ventriculostomía. En nuestros tres pacientes portadores de quistes coloides del III ventrículo, la extirpación fue completa, con seguimiento entre 6 y 18 meses. En 12 pacientes se realizaron extirpaciones parciales o biopsia tumoral. Resultados: en 15 pacientes se realizó diagnóstico histológico y en 3 de ellos fue posible la resección del tumor. En 10 pacientes se realizó III ventriculostomía como tratamiento ...