Pathophysiology and Treatment of Multiloculated Hydrocephalus

Intraventricular endoscopy and intraventricular antibiotics in the treatment of multiloculated hydrocephalus with ventriculitis in a neonate and an infant: Two case reports

“…This approach avoids the excessive risk of morbidity and mortality from placing multiple ventricular catheters, such as an increased risk of infections and a high probability of requiring multiple re-interventions due to catheter obstructions. [ 2 , 7 - 10 , 21 , 22 , 26 ]…”

“…In addition, we utilized the experience of one of our colleagues (a skull base specialist neurosurgeon) in cerebral endoscopy. [ 1 , 5 , 6 , 13 , 19 , 21 , 22 , 24 ]…”

“…is approach avoids the excessive risk of morbidity and mortality from placing multiple ventricular catheters, such as an increased risk of infections and a high probability of requiring multiple reinterventions due to catheter obstructions. [2,[7][8][9][10]21,22,26] After determining that ventricular septostomy was the best treatment option, we decided whether to use a craniotomy or an intraventricular endoscopic approach. Initially, we believed that open surgery by means of a wide craniotomy was the optimal choice because of the complexity of the case and the relative ease of the microsurgical approach with greater control of hemostasis.…”

“…In addition, we utilized the experience of one of our colleagues (a skull base specialist neurosurgeon) in cerebral endoscopy. [1,5,6,13,19,21,22,24] Because the results were very effective and without associated morbidity, we used this endoscopic technique in the second pediatric case. us, intraventricular endoscopic septostomy is currently one of the first choices for treating septate hydrocephalus to minimize morbidity and the number of ventricular catheters required.…”

“…[27] Multiloculated hydrocephalus is usually associated with neonatal age and the presence of intraventricular hemorrhage due to premature birth or neonatal meningitis. [22] In the case of ventriculitis, multiloculated hydrocephalus perpetuates infection because the formation of septate cavities makes it impossible for systemic or intraventricular antibiotics to circulate freely. For this reason, it is essential to communicate with all septate cavities to treat infection and hydrocephalus with the fewest ventricular systems.…”