Success rate of endoscopic third ventriculostomy in infants below six months of age with congenital obstructive hydrocephalus (a preliminary study of eight cases)

Zohdi, Ahmed; Damaty, Ahmed El; Aly, K. B.; Refaee, Ehab Ahmed El

doi:10.4103/1793-5482.121686

Cited by 21 publications

(12 citation statements)

References 32 publications

(55 reference statements)

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“…Endoscopic techniques are increasingly being used in spine,[ 208 209 210 ] skull base[ 211 212 213 ] and intracranial pathologies. [ 214 215 216 ] Endoscopic technique can be used alone in TN[ 217 218 ] or as an adjuvant to microscope[ 219 220 221 ] It is a minimally invasive technique,[ 221 222 ] allows better visualization of entire root from pons to ganglion[ 217 222 223 ] including ventral aspect. [ 223 ] The endoscope is a valuable tool during MVD, especially when a bony ridge hiding the direct microscopic view of vascular conflict.…”

Section: Endoscopic Vascular Decompressionmentioning

confidence: 99%

Trigeminal neuralgia

Yadav

Pande

et al. 2017

Asian J Neurosurg

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Trigeminal neuralgia (TN) is a sudden, severe, brief, stabbing, and recurrent pain within one or more branches of the trigeminal nerve. Type 1 as intermittent and Type 2 as constant pain represent distinct clinical, pathological, and prognostic entities. Although multiple mechanism involving peripheral pathologies at root (compression or traction), and dysfunctions of brain stem, basal ganglion, and cortical pain modulatory mechanisms could have role, neurovascular conflict is the most accepted theory. Diagnosis is essentially clinically; magnetic resonance imaging is useful to rule out secondary causes, detect pathological changes in affected root and neurovascular compression (NVC). Carbamazepine is the drug of choice; oxcarbazepine, baclofen, lamotrigine, phenytoin, and topiramate are also useful. Multidrug regimens and multidisciplinary approaches are useful in selected patients. Microvascular decompression is surgical treatment of choice in TN resistant to medical management. Patients with significant medical comorbidities, without NVC and multiple sclerosis are generally recommended to undergo gamma knife radiosurgery, percutaneous balloon compression, glycerol rhizotomy, and radiofrequency thermocoagulation procedures. Partial sensory root sectioning is indicated in negative vessel explorations during surgery and large intraneural vein. Endoscopic technique can be used alone for vascular decompression or as an adjuvant to microscope. It allows better visualization of vascular conflict and entire root from pons to ganglion including ventral aspect. The effectiveness and completeness of decompression can be assessed and new vascular conflicts that may be missed by microscope can be identified. It requires less brain retraction.

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Section: Endoscopic Vascular Decompressionmentioning

confidence: 99%

Trigeminal neuralgia

Yadav

Pande

et al. 2017

Asian J Neurosurg

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“…Zohdi et al published a prospective series of 8 cases of infants below six months who underwent ETV as primary treatment of congenital obstructive hydrocephalus. ETV was efficient in one case only and the study was discontinued [16]. In the same way, Helseth et al in 2000 reported SR of 62% for patients above 6 months and only an 8% success for those younger than 6 months of age.…”

Section: Etv Success Rates In Children Less Than 2 Yearsmentioning

confidence: 79%

Endoscopic Third Ventriculostomy for Non-Tumor Obstructive Hydrocephalus in Children under Two Years of Age

Ndoumbe¹,

Motah²,

Takongmo³

2015

OJMN

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The goal of this work is to report on the efficacy of endoscopic third ventriculostomy (ETV) for non-tumor obstructive hydrocephalus in children aged two years and below. In the period between June 2007 and December 2014, we had performed ETV in 30 patients with hydrocephalus from diverse etiologies. Among them were eight children aged two years or below. Clinical, radiological and outcome data of these children were retrospectively reviewed to assess ETV efficiency in this age group. Eight children (6 boys, 2 girls) with age range from 6 to 24 months (mean 12.5 months, median 15 months) suffering from non-tumor obstructive hydrocephalus underwent ETV as primary treatment. Seven patients (87.5%) were under two years and 3 had less than one year of age at the time of surgery. Macro crania, suture diastasis, scalp vein bulging and sunset gaze were the most common findings on physical examination. Computed tomography scanning was done in all patients but none had magnetic resonance imaging. Hydrocephalus was due to primary (congenital) aqueductal stenosis in all cases and was associated with myelomeningocele in one. ETV was successful in 7 (87.50%) cases but failed in one. Operation time varied from 28 to 35 minutes (mean 31.12 minutes, median 31.5 minutes). No intraoperative complication occurred. The child in whom ETV failed had postoperative CSF leak. No death related to procedure occurred. Hospital stay ranged from 2 to 4 days (mean, 2.87 days, median, 3 days). Follow up range was 5.5 to 86 months (0.46 to 7.16 years); mean, 59.14 months (4.92 years); median, 45.75 months (3.81 years).

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“…In spite of its numerous advantages in treating obstructive hydrocephalus, ETV is still not widely or routinely used in Sub-Saharan African countries like Cameroon. Besides the works of Benjamin C Warf in Uganda [5]- [7] [10], we found only five reports addressing this procedure in Africa: two in Nigeria [1] [3], one in Malawi by Kamalo P [2], one in Kenya and Tanzania by Piquer et al [4], one in South Africa [11], and one in Egypt [12]. This is really surprising because ETV is much more crucially advantageous in Africa where shunt related problems are very difficult to manage appropriately compared to developed countries.…”

Section: Sub-saharan Africa Contextmentioning

confidence: 99%

“…In Uganda in 2005, Warf BC [8] had reported success rates of 81% and 90% in children older than 1 year depending on etiology. [12]. Post-infectious, post-haemorrhagic and previously shunted hydrocephalies were also considered contra-indications for ETV.…”

Section: Success Rates Of Etvmentioning

confidence: 99%

Non-Tumor Obstructive Hydrocephalus Treated with Endoscopic Third Ventriculostomy in Cameroon

Ndoumbe¹,

Simeu²,

Motah³

2015

OJMN

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Objective: In Sub-Saharan Africa, shunt dependence is a real threat for patients. For this reason, any method allowing shunt independence such as endoscopic third ventriculostomy should be promoted. The goal of this study was to show the advantages of neuroendoscopy in treating nontumor obstructive hydrocephalus in Cameroon. Methods: We retrospectively reviewed the cases of non-tumor obstructive hydrocephalus treated with endoscopic third ventriculostomy in our hospital. Results: Twenty patients (15 males, 5 females) underwent endoscopic third ventriculostomy as first choice treatment for non-tumor obstructive hydrocephalus. Their ages ranged from six months to 41 years (mean 11.96 years, median 20.75 years). Fourteen patients (70%) were children (≤18 years old), 6 were adults, 7 were under age of two years and 3 were below one. Computed tomography scan was the radiological tool used in all cases. None did a magnetic resonance imaging scan. Etiology of hydrocephalus was aqueductal stenosis in 18 cases and stenosis of the foramina of Luschka & Magendie in two. Aqueductal stenosis was associated with myelomeningocele in one case and shunt failure in another one. Endoscopic third ventriculostomy was successful in alleviating clinical symptoms with shunt independence in 19 cases (95%), but failed in one case. ETV success was not related to patient age. Cerebrospinal fluid leak occurred in two patients as post-operative complication (10%). Overall, ETV diminished treatment cost by 600 USD. Conclusion: Even in areas with limited medical equipment like in Sub-Saharan Africa where shunt dependence is a real danger, ETV can be routinely used to successfully treat non-tumor obstructive hydrocephalus.

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Success rate of endoscopic third ventriculostomy in infants below six months of age with congenital obstructive hydrocephalus (a preliminary study of eight cases)

Cited by 21 publications

References 32 publications

Trigeminal neuralgia

Trigeminal neuralgia

Endoscopic Third Ventriculostomy for Non-Tumor Obstructive Hydrocephalus in Children under Two Years of Age

Non-Tumor Obstructive Hydrocephalus Treated with Endoscopic Third Ventriculostomy in Cameroon

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