Endoscopic third ventriculostomy: An outcome analysis of 30 pediatric cases

OBJECTIVE: Endoscopic third ventriculostomy (ETV) has been shown to be a sufficient alternative in the surgical treatment of hydrocephalus. Our goal in this retrospective study is to analyze our results with the use of ETV in our first 30 cases that it may provide us with selection criteria as to who among our patients will benefit most from this procedure.METHODOLOGY: Thirty ETVs were performed in 30 patients. Their ages ranged from 2-155 months. Hydrocephalus was caused by aqueductal stenosis in 17 patients, tumors in 7, post-infectious in 3, Dandy-Walker malformation in 2 and arachnoid cyst in 1 patient. The outcome of ETV was evaluated in 26 of the cases that were available for follow-up RESULTS: The overall success rate was 69.2 percent. Patients with non-communicating hydrocephalus from post-infectious causes, tumors and aqueductal stenosis had high success rates. Patients less than 6 months of age had a poor outcome. Complications included ventriculitis in 1 patient CONCLUSION: ETV is a viable treatment option for non-communicating hydrocephalus secondary to post-infectious cause, aqueductal stenosis and tumors. A successful outcome is more likely if ETV is done in patients more than 6 months of age Patients who have previously undergone shunting and who have non-communicating hydrocephalus should undergo ETV at the time of shunt failure. These patients showed good outcome.

Tersons syndrome as a prognosticating factor in aneurysmal subarachnoid hemorrhage

This is a descriptive study of Tersons syndrome among patients with aneurysmal subarachnoid hemorrhage at the Philippine General Hospital. The incidence of Tersons syndrome was 13.4 percent. There were no statistically significant differences in outcomes among patients with and without Tersons syndrome. (Author)

Terson's syndrome: Not a prognosticating factor of aneurysmal subarachnoid hemorrhage

Terson's syndrome has been implicated by previous studies as a strong predictor of poor outcome of patients with subarachnoid hemorrhage. There was even a recommendation to place patients with the syndrome in the next less favorable category. Hence this study was designed to provide a general profile of patients with Terson's syndrome and investigate whether the syndrome correlates with poor outcome. This study was done using a prospective cohort of patients seen at the Philippine General Hospital pay and charity wards from July 1, 1999 to June 30, 2000 diagnosed to have aneurysmal subarachnoid hemorrhage. Detailed ophthalmological examination was done and data were collected using a standard database. Patients were then followed up at 2 weeks, 1 month and 3 months to determine outcome (using Glasgow Outcome Score). Data collected were subjected to univariate analysis using chi square and/or Fisher test to determine significant correlation of variables with Terson's syndrome and to determine significance of Terson's syndrome as a predictor of poor outcome. A total of 52 patients were included in the study. The general demographic profile of patients with Terson's syndrome was comparable to that of the study population. The frequency of Terson's syndrome was 13.4 percent. There were no statistically significant differences in outcomes among patients with and without Terson's syndrome. However, positive correlation between laterality of Terson's syndrome with the side of aneurysm was shown. Although results were not significant, funduscopic examination remains to be warranted as an important part of diagnostic work-up of aneurysmal subarachnoid hemorrhage patients. When present, the laterality of Terson's syndrome may give a clue to the presence and side of the aneurysm.

Intracranial neoplasms: A ten year experience

The epidemiologic features of 652 histologically confirmed intracranial tumors were reviewed. 600 were primary tumors and 52 were metastatic. 17.4% of all tumors were gliomas and 23.2% were meningiomas. 73% of adult tumors were supratentorial, most commonly meningiomas, while 10% of pediatric tumors (age14) were infratentorial, predominantly medulloblastomas. There was an equal distribution of the tumors in the first decades of life. The medulloblastomas and astrocytoma I-II, peaked in early childhood whereas meningiomas, neurilemmomas and metastatic tumors increased in frequency with advancing age. The overall risk for intracranial tumors was the same for both sexes. However, women had greater susceptibility for meningiomas, pituitary adenomas and merilemmomas. The features of intracranial tumors in Filipinos mirrored those seen in Blacks and other Asians, and differed from most Western profiles. It is possible that racial difference play a role in the development of intracranial tumors.