Advertisement

Child's Nervous System

, Volume 20, Issue 11–12, pp 868–877 | Cite as

Long-term complications and definition of failure of neuroendoscopic procedures

  • Tjemme BeemsEmail author
  • J. Andre Grotenhuis
Original Paper

Abstract

Objects

A lot has been published about neuroendoscopic procedures over the last decade. Most of these publications are about the effectiveness of endoscopic third ventriculostomy, the most frequently performed neuroendoscopic procedure. Little is published about the effectiveness of other, less frequently performed neuroendoscopic procedures. Over the years more reports about the complications of endoscopic procedures are published, but again most of these publications are about endoscopic third ventriculostomy and only a little is presented about the complications of all other neuroendoscopic procedures. Furthermore, most reports are about intraoperative and immediate postoperative complications; only a few reports evaluated the long-term complications of neuroendoscopic procedures. There are also a few publications that analyse the failures of neuroendoscopic procedures but a good definition of failure is not given. The reports mention, again, mainly endoscopic third ventriculostomy procedures, and are mostly directed at the short-term failure rates, defined as the need for a shunt to be placed. Less attention is paid to the effects of the endoscopic procedures in the longer term. Looking at longer terms emphasises the need for a better definition of failure.

Methods

To get more insight into the long-term complications and failures of neuroendoscopic procedures, we reviewed the literature and evaluated our own series of 485 different cranial endoscopic procedures. With the information gathered we tried to answer the questions mentioned above.

Conclusions

Most of the complications of neuroendoscopic procedures are transient, either spontaneously or by medical intervention. Only a few permanent complications are known, in our series 1.6%, and most of them are not typically related to the endoscopic procedure itself but are due to the ventricular approach necessary for and the management of the endoscopy. Mortality rates are less than 1%. A uniform definition of failure cannot be given for all neuroendoscopic procedures, because the procedures are too heterogeneous and the indications are widespread. Failures are mainly diagnosed within a few months of the procedure but neurosurgeons must be aware of failure in the longer term, because if not diagnosed they can give rise to increased morbidity and probably mortality.

Keywords

Failure Long term Morbidity Mortality Neuroendoscopy Success rate 

References

  1. 1.
    Abtin K, Thompson BG, Walker ML (1998) Basilar artery perforation as a complication of endoscopic third ventriculostomy. Pediatr Neurosurg 28:35–41CrossRefPubMedGoogle Scholar
  2. 2.
    Baskin JJ, Manwaring KH, Rekate HL (1998) Ventricular shunt removal: the ultimate treatment of the slit ventricle syndrome. J Neurosurg 88:478–484PubMedGoogle Scholar
  3. 3.
    Brockmeyer D, Abtin K, Carey L et al (1998) Endoscopic third ventriculostomy: an outcome analysis. Pediatr Neurosurg 28:236–240CrossRefPubMedGoogle Scholar
  4. 4.
    Buxton N, Punt J (2000) Cerebral infarction after neuroendoscopic third ventriculostomy: case report. Neurosurgery 46:999–1002PubMedGoogle Scholar
  5. 5.
    Buxton N, Macarthur D, Malluci C et al (1998) Neuroendoscopic third ventriculostomy in patients less than 1 year old. Pediatr Neurosurg 29:73–76PubMedGoogle Scholar
  6. 6.
    Choi JU, Kim DS, Kim SH (1999) Endoscopic surgery for obstructive hydrocephalus. Yonsei Med J 40:600–607PubMedGoogle Scholar
  7. 7.
    Cinalli G, Salazar C, Malluci C et al (1998) The role of endoscopic third ventriculostomy in the management of shunt malfunction. Neurosurgery 43:1323–1329PubMedGoogle Scholar
  8. 8.
    Cinalli G, Sainte-Rose C, Chumas P, Zerah M, Brunelle F, Lot G, Pierre Kahn A, Renier D (1999) Failure of third ventriculostomy in the treatment of aqueductal stenosis in children. J Neurosurg 90:448–454PubMedGoogle Scholar
  9. 9.
    Dandy WE (1922) Cerebral ventriculoscopy. Johns Hopkins Hosp Bull 33:189–190Google Scholar
  10. 10.
    Decq P, Le Guerinel C, Brugieres P et al (1998) Endoscopic management of colloid cysts. Neurosurgery 42:1288–1296PubMedGoogle Scholar
  11. 11.
    Di Rocco C, Marchese E, Velardi F (1994) A survey of the first complication of newly implanted CSF shunt devices for the treatment of nontumoral hydrocephalus. Cooperative survey of the 1991–1992 Education Committee of the ISPN. Childs Nerv Syst 10:321–327PubMedGoogle Scholar
  12. 12.
    Di Roio C, Mottolese C, Cayrel V et al (1999) Ventriculostomie du troisième ventricule et diabete insipide. Ann Fr Anesth Reanim 18:776–778CrossRefPubMedGoogle Scholar
  13. 13.
    Doczi T, Veto F, Horvath Z (1998) Clinical analysis of 89 consecutive 3rd ventriculostomies [abstract]. Minim Invasive Neurosurg 41:112Google Scholar
  14. 14.
    Enya S, Masuda Y, Terui K (1997) Respiratory arrest after a ventriculoscopic surgery in infants: two case reports. Masui 46:416–420PubMedGoogle Scholar
  15. 15.
    Fay T, Grant FC (1923) Ventriculoscopy and intraventricular photography in internal hydrocephalus. JAMA 80:461–463Google Scholar
  16. 16.
    Freudenstein D, Wagner A, Ernemann U, Duufner F (2002) Subdural hygroma as a complication of endoscopic neurosurgery. Two case reports. Neurol Med Chir (Tokyo) 42:554–559Google Scholar
  17. 17.
    Fukuhara T, Vorster SJ, Luciano MG (2000) Risk factors for failure of endoscopic third ventriculostomy for obstructive hydrocephalus. Neurosurgery 46:1100–1111PubMedGoogle Scholar
  18. 18.
    Fukushima T, Ishijima B, Hirakawa K, Nakamura N, Sano K (1973) Ventriculofiberscope: a new technique for endoscopic diagnosis and operation. Technical note. J Neurosurg 38:251–256PubMedGoogle Scholar
  19. 19.
    Gaab MR, Schroeder HW (1998) Neuroendoscopic approach to intraventricular lesions. J Neurosurg 88:496–505PubMedGoogle Scholar
  20. 20.
    Griffith HB (1975) Technique of fontanelle and persutural ventriculoscopy and ventricular surgery in infants. Childs Brain 1:359–363PubMedGoogle Scholar
  21. 21.
    Guiot G (1973) Ventriculo-cisternostomy for stenosis of the aqueduct of Sylvius. Puncture of the floor of the third ventricle with a leucotome under television control. Acta Neurochir 28:275–289PubMedGoogle Scholar
  22. 22.
    Hopf NJ, Grunert P, Fries G, Resch KD, Perneczky A (1999) Endoscopic third ventriculostomy: outcome analysis of 1000 consecutive procedures. Neurosurgery 44:795–806PubMedGoogle Scholar
  23. 23.
    Jones RF, Kwok BC, Stening WA, Vonau M (1994) The current status of endoscopic third ventriculostomy in the management of non-communicating hydrocephalus. Minim Invas Neurosurg 37:28–36Google Scholar
  24. 24.
    Jones RFC, Stening WA, Brydon M (1990) Endoscopic third ventriculostomy. Neurosurgery 26:86–92PubMedGoogle Scholar
  25. 25.
    Kehler U, Gliemroth J, Knopp U et al (1998) How to perforate safely a resistant floor of the 3rd ventricle? Technical note. Minim Invasive Neurosurg 41:198–199PubMedGoogle Scholar
  26. 26.
    Kumar R, Behari S, Wahi J et al (1999) Peduncular hallucinosis: an unusual sequel to surgical intervention in the suprasellar region. Br J Neurosurg 13:500–503CrossRefPubMedGoogle Scholar
  27. 27.
    Kunz U, Goldmann A, Bader C et al (1994) Endoscopic fenestration of the 3rd ventricular floor in aqueductal stenosis. Minim Invasive Neurosurg 16:42–47Google Scholar
  28. 28.
    Lewis A, Crone KR (1994) Advances in neuroendoscopy. Contemp Neurosurg 16:1–6Google Scholar
  29. 29.
    McLaughlin MR, Wahlig JB, Kaufmann AM et al (1997) Traumatic basilar aneurysm after endoscopic third ventriculostomy: case report. Neurosurgery 41:1400–1404PubMedGoogle Scholar
  30. 30.
    Mixter WJ (1923) Ventriculoscopy and puncture of the floor of the third ventricle. Preliminary report of a case. Boston Med Surg J 188:277–278Google Scholar
  31. 31.
    Oi S, Shibata M, Tominaga J, Honda Y, Shinoda M, Takei F, Tsugane R, Matsuzawa K, Sato O (2000) Efficacy of neuroendoscopic procedures in minimally invasive preferential management of pineal region tumours: a prospective study. J Neurosurg 93:245–253PubMedGoogle Scholar
  32. 32.
    Oka K, Yamamoto M, Ikeda K et al (1993) Flexible endoneurosurgical therapy for aqueductal stenosis. Neurosurgery 33:236–243PubMedGoogle Scholar
  33. 33.
    Pople IK, Athanasiou TC, Sandeman DR, Coakham HB (2001) The role of endoscopic biopsy and third ventriculostomy in management of pineal region tumours. Br J Neurosurg 15:305–311CrossRefPubMedGoogle Scholar
  34. 34.
    Putnam TJ (1934) Treatment of hydrocephalus by endoscopic coagulation of the choroid plexus. Description of a new instrument and preliminary report of results. N Engl J Med 210:1373–1376Google Scholar
  35. 35.
    Robinson S, Cohen AR (1997) The role of neuroendoscopy in the treatment of pineal region tumours. Surg Neurol 48:360–365CrossRefPubMedGoogle Scholar
  36. 36.
    Sainte-Rose C, Chumas P (1996) Endoscopic third ventriculostomy. Tech Neurosurg 1:167–184Google Scholar
  37. 37.
    Sainte-Rose C, Hoffman HJ, Hirsch JF (1989) Shunt failure. In: Marlin AE (ed) Concepts in pediatric neurosurgery. Karger, Basel, pp 7–20Google Scholar
  38. 38.
    Scarff JE (1935) Third ventriculostomy as the rational treatment of obstructive hydrocephalus. J Pediatr 6:870–871Google Scholar
  39. 39.
    Schmidt RH (1999) Use of microvascular Doppler probe to avoid basilar artery injury during endoscopic third ventriculostomy. J Neurosurg 90:156–159PubMedGoogle Scholar
  40. 40.
    Schroeder HWS, Warzok RW, Assaf JA et al (1999) Fatal subarachnoid hemorrhage after endoscopic third ventriculostomy. Case report. J Neurosurg 90:153–155PubMedGoogle Scholar
  41. 41.
    Schroeder HWS, Niendorf WG, Gaab MR (2002) Complications of endoscopic third ventriculostomy. J Neurosurg 96:1032–1040PubMedGoogle Scholar
  42. 42.
    Teo C (1998) Third ventriculostomy in the treatment of hydrocephalus: experience with more than 120 cases. In: Hellwig D, Bauer BL (eds) Minimally invasive techniques for neurosurgery. Springer, Berlin Heidelberg New York, pp 73–76Google Scholar
  43. 43.
    Teo C, Rahman S, Boop F (1995) Complications of endoscopic surgery [abstract]. Childs Nerv Syst 11:539Google Scholar
  44. 44.
    Vandertop WP, Verdaasdonk RM, van Swol CFP (1998) Laser-assisted neuroendoscopy using a neodymium-yttrium aluminium garnet or diode contact laser with pretreated fiber tips. J Neurosurg 88:82–92PubMedGoogle Scholar
  45. 45.
    Vries JK (1978) An endoscopic technique for third ventriculostomy. Surg Neurol 13:165–168Google Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  1. 1.Department of NeurosurgeryUniversity Medical CentreNijmegenThe Netherlands

Personalised recommendations