Garg A, Suri A, Chandra P S, Kumar R, Sharma B S, Mahapatra A K
Department of Neurosurgery, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India.
Pediatr Neurosurg. 2009;45(1):1-5. doi: 10.1159/000202617. Epub 2009 Feb 17.
Endoscopic third ventriculostomy (ETV) is one of the efficacious surgical options available for obstructive hydrocephalus, and is preferable to a ventriculoperitoneal shunt in those eligible. We retrospectively studied 115 cases, who underwent ETV at our institute over the last 5 years. Thirty-eight patients were infants. Major indications for ETV were aqueductal stenosis (n = 60/115, 52.2%), Dandy-Walker malformation (15/115, 13%), associated arachnoid cyst (n = 13/115, 11.3%) and post-meningitic hydrocephalus (n = 12/115, 10.4%). Average duration of the follow-up was 10.6 months. Ninety-nine patients (86.1%) showed clinical improvement after surgery. Clinical improvement was seen in 27 out of 38 infants (71%) followed up. ETV is a highly effective tool in all age groups of patients for the management of hydrocephalus. Clinical features should be considered as indications of the success or failure of ventriculostomy in infants who have low-pressure hydrocephalus.
内镜下第三脑室造瘘术(ETV)是治疗梗阻性脑积水的有效手术选择之一,对于符合条件的患者,它比脑室腹腔分流术更可取。我们回顾性研究了过去5年在我院接受ETV手术的115例患者。38例患者为婴儿。ETV的主要适应证为导水管狭窄(n = 60/115,52.2%)、Dandy-Walker畸形(15/115,13%)、合并蛛网膜囊肿(n = 13/115,11.3%)和脑膜炎后脑积水(n = 12/115,10.4%)。平均随访时间为10.6个月。99例患者(86.1%)术后临床症状改善。在随访的38例婴儿中,27例(71%)临床症状改善。ETV是各年龄组患者治疗脑积水的高效工具。对于患有低压脑积水的婴儿,临床特征应被视为脑室造瘘术成功或失败的指标。