Endoscopic third ventriculostomy in the treatment of hydrocephalus secondary to posterior fossa tumours in children

ABSTRACT

The purpose of the present study is to describe our experience with endoscopic third ventriculostomy in children with obstructive hydrocephalus secondary to posterior fossa tumours. Between January 2000 and January 2006, 42 children with posterior fossa tumour were treated. Thirty patients had symptomatic hydrocephalus. Third ventriculostomy was performed to relieve intracranial pressure in all cases as an urgent procedure after admission. The other 12 cases had no hydrocephalus or non symptomatic mild dilatation of ventricles. They were excluded from the study. Pre craniectomy endoscopic third ventriculostomy procedures were technically successful. One case was complicated with infection. The procedure resolved the increased intracranial pressure before posterior fossa surgery in all cases. One case developed post operative hydrocephalus and was treated by ventriculo-peritoneal shunt insertion. Endoscopic third ventriculostomy is a plausible choice for the emergency control of severe hydrocephalus caused by posterior fossa tumours. It can quickly eliminate symptoms. In addition, it eliminates the risks of cerebrospinal fluid infection related to external drainage, minimizes the risk of over drainage because it provides more physiological cerebrospinal fluid drainage than the other procedures and avoids the complications of shunting procedures