Skip to main content

Endoscopic third ventriculostomy in children younger than 2 years of age

Child's Nervous System volume 23, pages 623–626 (2007)Cite this article

Abstract

Introduction

Endoscopic third ventriculostomy (ETV) for the treatment of hydrocephalus of different etiologies is still controversial in children younger than 2 years of age. The success rate of ETV in this group of patients is analyzed in this study.

Materials and methods

The series consisted of 21 patients treated with ETV. The mean age of the patients was 6.7 months, ranging from 9 days to 15 months (16 patients were younger than 1 year). The study included hydrocephalus due to idiopathic aqueductal stenosis (eight) and other congenital anomalies (four) as well as posthemorrhagic (three) and tumor-related occlusive hydrocephalus (three). Two patients presented with shunt infection and one with a shunt failure. ETV was considered to be successful when shunting could be avoided.

Results

ETV was successful in nine patients, with a mean follow-up period of 26.2 months. The procedure was successful in four patients with idiopathic aqueductal stenosis, in two with other congenital anomalies, in one posthemorrhagic, and in two with a tumor-related hydrocephalus. In 12 patients, the ETV was unsuccessful after a mean follow-up of 3.3 months. These patients required a shunt. Ten of them were less than 1 year old when ETV was performed. In one tumor-related hydrocephalus, a shunt was inserted after a meningitis after tumor removal.

Conclusions

The success of ETV in children younger than 2 years of age suffering from non-communicating hydrocephalus seems to be dependent on both age and etiology. Our results show an overall success rate of 43%. In 37.5% of the children younger than 1 year of age, ETV was successful. ETV in patients with hydrocephalus due to idiopathic aqueductal stenosis seems to be more beneficial than in other causes of hydrocephalus.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2

References

  1. Jones RF, Stening WA, Brydon M (1990) Endoscopic third ventriculostomy. Neurosurgery 26:86–92

    PubMed  Article  CAS  Google Scholar 

  2. Jones RF, Kwok BC, Stening WA, Vonau M (1994) The current status of endoscopic third ventriculostomy in the management of non-communicating hydrocephalus. Minim Invasive Neurosurg 37:28–36

    PubMed  CAS  Google Scholar 

  3. Kunz U, Goldmann A, Bader C, Waldbauer H, Oldenkott P (1994) Endoscopic fenestration of the 3rd ventricular floor in aqueductal stenosis. Minim Invasive Neurosurg 37:42–47

    PubMed  CAS  Google Scholar 

  4. 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, pp 73–76

    Google Scholar 

  5. Hellwig D, Grotenhuis JA, Tirakotai W, Riegel T, Schulte DM, Bauer BL, Bertalanffy H (2005) Endoscopic third ventriculostomy for obstructive hydrocephalus. Neurosurg Rev 28:1–34

    PubMed  Article  Google Scholar 

  6. Brockmeyer D, Abtin K, Carey L, Walker ML (1998) Endoscopic third ventriculostomy: an outcome analysis. Pediatr Neurosurg 28:236–240

    PubMed  Article  CAS  Google Scholar 

  7. Gangemi M, Donati P, Maiuri F, Longatti P, Godano U, Mascari C (1999) Endoscopic third ventriculostomy for hydrocephalus. Minim Invasive Neurosurg 42:128–132

    PubMed  CAS  Google Scholar 

  8. Schroeder HWS, Niendorf WR, Gaab MR (2002) Complications of endoscopic third ventriculostomy. J Neurosurg 96:1032–1040

    PubMed  Google Scholar 

  9. Beems T, Grotenhuis JA (2004) Long-term complications and definition of failure of neuroendoscopic procedures. Childs Nerv Syst 20:868–877

    PubMed  Article  Google Scholar 

  10. Kadrian D, van Gelder J, Florida D, Jones R, Vonau M, Teo C, Stening W, Kwok B (2005) Long-term reliability of endoscopic third ventriculostomy. Neurosurgery 56:1271–1278 (discussion 1278)

    PubMed  Article  Google Scholar 

  11. Buxton N, MacArthur D, Mallucci C, Punt J, Vloeberghs M (1998) Neuroendoscopic third ventriculostomy in patients less than one year old. Pediatr Neurosurg 29:73–76

    PubMed  Article  CAS  Google Scholar 

  12. Beems T, Grotenhuis JA (2002) Is the success of endoscopic third ventriculostomy age-dependent? An analysis of the results of endoscopic third ventriculostomy in children. Childs Nerv Syst 18:605–608

    PubMed  Article  Google Scholar 

  13. Koch D, Wagner W (2004) Endoscopic third ventriculostomy in infants of less than 1 year of age: which factors influence outcome. Childs Nerv Syst 20:405–411

    PubMed  Article  Google Scholar 

  14. Gorayeb RP, Cavalheiro S, Zymberg ST (2004) Endoscopic third ventriculostomy in children younger than 1 year of age. J Neurosurg (Pediatrics) 100:427–429

    Google Scholar 

  15. Teo C, Jones R (1996) Management of hydrocephalus by endoscopic third ventriculostomy in patients with myelomeningocele. Pediatr Neurosurg 25:57–63

    PubMed  CAS  Article  Google Scholar 

  16. 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 90:448–454

    PubMed  CAS  Google Scholar 

  17. Kim SK, Wang KC, Cho BK (2000) Surgical outcome of pediatric hydrocephalus treated by endoscopic III ventriculostomy: prognostic factors and interpretation of postoperative neuroimaging. Childs Nerv Syst 16:161–169

    PubMed  Article  CAS  Google Scholar 

  18. Elbabaa SK, Steinmetz M, Ross J, Moon D, Luciano MG (2001) Endoscopic third ventriculostomy for obstructive hydrocephalus in the pediatric population: evaluation of outcome. Eur J Pediatr Surg 11(Suppl 1):S52–S54 (411)

    PubMed  Google Scholar 

  19. Javadpour M, Mallucci C, Brodbelt A, Golash A, May P (2001) The impact of endoscopic third ventriculostomy on the management of newly diagnosed hydrocephalus in infants. Pediatr Neurosurg 35:188–194

    Article  Google Scholar 

  20. Fritsch MJ, Kehler U, Joedicke A, Boschert J, Wagner W (2005) Endoscopic third ventriculostomy in infants under one year of age: a German multicenter study. Childs Nerv Syst 21:495 (data presented at the Third World Meeting of the ISGNE in Marburg 2005)

    Google Scholar 

  21. Hayashi N, Hamada H, Hirashima Y, Kurimoto M, Takaku A, Endo S (2000) Clinical features in patients requiring reoperation after failed endoscopic procedures for hydrocephalus. Minim Invasive Neurosurg 43:181–186

    PubMed  Article  CAS  Google Scholar 

  22. Sainte-Rose C, Cinalli G, Roux FE, Maixner R, Chumas PD, Mansour M, Carpentier A, Bourgeois M, Zerah M, Pierre- Kahn A, Renier D (2001) Management of hydrocephalus in pediatric patients with posterior fossa tumors: the role of endoscopic third ventriculostomy. J Neurosurg 95:791–797

    PubMed  CAS  Article  Google Scholar 

  23. Wellons JC III, Tubbs RS, Banks JT, Grabb B, Blont JP, Oakes WJ, Grabb PA (2002) Long-term control of hydrocephalus via endoscopic third ventriculostomy in children with tectal plate gliomas. Neurosurgery 51:63–67

    PubMed  Article  Google Scholar 

  24. Ruggiero C, Cinalli G, Spennato P, Aliberti F, Cianciulli E, Trischitta V, Maggi G (2004) Endoscopic third ventriculostomy in the treatment of hydrocephalus in posterior fossa tumors in children. Childs Nerv Syst 20:828–833

    PubMed  Article  Google Scholar 

Download references

Author information

Affiliations

  1. Department of Neurosurgery, Ernst-Moritz-Arndt University, Sauerbruchstrasse, 17475, Greifswald, Germany

    Jörg Baldauf & Henry W. S. Schroeder

  2. Department of Neurosurgery, Nordstadt Hospital, Hannover, Germany

    J. Oertel & Michael R. Gaab

Authors
  1. Jörg Baldauf
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Oertel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael R. Gaab
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Henry W. S. Schroeder
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Henry W. S. Schroeder.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Baldauf, J., Oertel, J., Gaab, M.R. et al. Endoscopic third ventriculostomy in children younger than 2 years of age. Childs Nerv Syst 23, 623–626 (2007). https://doi.org/10.1007/s00381-007-0335-4

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-007-0335-4

Keywords

  • Endoscopic third ventriculostomy
  • Hydrocephalus
  • Children