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Changes in third ventricular size in pediatric patients undergoing endoscopic third ventriculostomy

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Abstract

Purpose

Optimal methods of evaluating radiographic data following endoscopic third ventriculostomy (ETV) are not yet known. This study analyzes imaging parameters, including third ventricular width and cross-sectional area (CSA), in pediatric ETV patients.

Methods

Hydrocephalic pediatric patients treated by ETV at the senior authors’ institution from 2004 to 2011 were stratified clinically (successful versus unsuccessful outcome) and retrospectively reviewed. Measured from pre- and post-operative imaging studies, third ventricular parameters included maximal width and mid-sagittal CSA, while lateral ventricular parameters included the ratio of greatest frontal horn width to co-linear skull internal diameter and the frontal-occipital horn ratio.

Results

Ten successful ETV patients (mean age 10.6 years; range 11 months to 19.8 years) obtained imaging at least 2.75 months following surgery, while four unsuccessful ETV patients (mean age 9.8 years; range 4 months to 17.3 years) underwent imaging before repeat intervention. Third ventricular width showed an average decline of 0.32 cm and 17.4 % in the successful ETV cohort, but average increases of 0.35 cm and 21.0 % in the ETV failure group. Successful ETV patients exhibited mean decreases of 1.85 cm2 and 19.7 % in third ventricular mid-sagittal CSA, while unsuccessful ETV patients showed mean increases of 1.17 cm2 and 17.3 % per patient. These differences were statistically significant. Measures of lateral ventricular size showed similar trends, but with lower magnitude.

Conclusions

Third ventricular imaging parameters (width and mid-sagittal CSA) exhibited more pronounced responses to ETV than lateral ventricular measurements in pediatric hydrocephalic patients.

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Acknowledgments

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics statement

This research study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Because all study subjects represented prior patients of the senior authors and identifying information was not reported nor used for the production of this manuscript, informed consent was not required for this retrospective study.

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Authors and Affiliations

  1. Division of Pediatric Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Jonathan Pindrik, George I. Jallo & Edward S. Ahn

  2. PGY-6, 600 North Wolfe Street, Phipps 560A, Baltimore, MD, 21287, USA

    Jonathan Pindrik

  3. Division of Pediatric Neurosurgery, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps 554A, Baltimore, MD, 21287, USA

    George I. Jallo

  4. Division of Pediatric Neurosurgery, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps 560A, Baltimore, MD, 21287, USA

    Edward S. Ahn

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  1. Jonathan Pindrik
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  2. George I. Jallo
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  3. Edward S. Ahn
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Correspondence to Edward S. Ahn.

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Pindrik, J., Jallo, G.I. & Ahn, E.S. Changes in third ventricular size in pediatric patients undergoing endoscopic third ventriculostomy. Childs Nerv Syst 29, 2027–2034 (2013). https://doi.org/10.1007/s00381-013-2145-1

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  • DOI: https://doi.org/10.1007/s00381-013-2145-1

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