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Neuroendoscopic treatment of multiloculated hydrocephalus in children.
J Neurosurg. 2007 Jan; 106(1 Suppl):29-35.JN

Abstract

OBJECT

The authors performed a retrospective analysis of data obtained in a series of 30 patients suffering from multiloculated hydrocephalus and treated endoscopically. The goal of the study was to evaluate the effectiveness of neuroendoscopic treatment as an alternative to the placement of multiple shunts to relieve intracranial hypertension, to simplify the shunt system, and to reduce the high rate of shunt revision.

METHODS

The endoscopic procedures included intraventricular septum fenestration, aqueductoplasty, Monro foraminoplasty, and third ventriculostomy. The patients were divided into two groups: Group A included 23 children in whom a shunt was already in place at the time of endoscopy, and Group B included seven children in whom a shunt had never been placed. The control of hydrocephalus by a single shunt placement or the absence of a shunt was achieved in 25 (83.3%) of 30 children. In Group A, five children no longer had shunts, 14 needed a single shunt, three required two shunts, and one required three shunts. The mean preendoscopy shunt revision rate in this group decreased from 2.07/year to 0.35/ year following the endoscopic procedure. Seven patients required endoscopic reoperations (endoscopic reoperation rate 0.31/year, total reoperation rate [shunt revisions plus endoscopic reoperation] 0.66/year). In Group B, three children did not require shunts, three needed a single shunt, and one required two shunts. Two patients required repeated endoscopic surgery (endoscopic reoperation rate 0.19/year), and two patients required shunt revisions (shunt revision rate 0.07/year) (total operation rate 0.26/year).

CONCLUSIONS

Neuroendoscopic procedures are a valid alternative to shunt revision in the management of multiloculated hydrocephalus. Early diagnosis comprising close monitoring with high-resolution magnetic resonance imaging and early treatment are the keys of success.

Authors+Show Affiliations

Department of Pediatric Neurosurgery, Santobono Children's Hospital, Naples, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17233309

Citation

Spennato, Pietro, et al. "Neuroendoscopic Treatment of Multiloculated Hydrocephalus in Children." Journal of Neurosurgery, vol. 106, no. 1 Suppl, 2007, pp. 29-35.
Spennato P, Cinalli G, Ruggiero C, et al. Neuroendoscopic treatment of multiloculated hydrocephalus in children. J Neurosurg. 2007;106(1 Suppl):29-35.
Spennato, P., Cinalli, G., Ruggiero, C., Aliberti, F., Trischitta, V., Cianciulli, E., & Maggi, G. (2007). Neuroendoscopic treatment of multiloculated hydrocephalus in children. Journal of Neurosurgery, 106(1 Suppl), 29-35.
Spennato P, et al. Neuroendoscopic Treatment of Multiloculated Hydrocephalus in Children. J Neurosurg. 2007;106(1 Suppl):29-35. PubMed PMID: 17233309.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neuroendoscopic treatment of multiloculated hydrocephalus in children. AU - Spennato,Pietro, AU - Cinalli,Giuseppe, AU - Ruggiero,Claudio, AU - Aliberti,Ferdinando, AU - Trischitta,Vincenzo, AU - Cianciulli,Emilio, AU - Maggi,Giuseppe, PY - 2007/1/20/pubmed PY - 2007/2/3/medline PY - 2007/1/20/entrez SP - 29 EP - 35 JF - Journal of neurosurgery JO - J Neurosurg VL - 106 IS - 1 Suppl N2 - OBJECT: The authors performed a retrospective analysis of data obtained in a series of 30 patients suffering from multiloculated hydrocephalus and treated endoscopically. The goal of the study was to evaluate the effectiveness of neuroendoscopic treatment as an alternative to the placement of multiple shunts to relieve intracranial hypertension, to simplify the shunt system, and to reduce the high rate of shunt revision. METHODS: The endoscopic procedures included intraventricular septum fenestration, aqueductoplasty, Monro foraminoplasty, and third ventriculostomy. The patients were divided into two groups: Group A included 23 children in whom a shunt was already in place at the time of endoscopy, and Group B included seven children in whom a shunt had never been placed. The control of hydrocephalus by a single shunt placement or the absence of a shunt was achieved in 25 (83.3%) of 30 children. In Group A, five children no longer had shunts, 14 needed a single shunt, three required two shunts, and one required three shunts. The mean preendoscopy shunt revision rate in this group decreased from 2.07/year to 0.35/ year following the endoscopic procedure. Seven patients required endoscopic reoperations (endoscopic reoperation rate 0.31/year, total reoperation rate [shunt revisions plus endoscopic reoperation] 0.66/year). In Group B, three children did not require shunts, three needed a single shunt, and one required two shunts. Two patients required repeated endoscopic surgery (endoscopic reoperation rate 0.19/year), and two patients required shunt revisions (shunt revision rate 0.07/year) (total operation rate 0.26/year). CONCLUSIONS: Neuroendoscopic procedures are a valid alternative to shunt revision in the management of multiloculated hydrocephalus. Early diagnosis comprising close monitoring with high-resolution magnetic resonance imaging and early treatment are the keys of success. SN - 0022-3085 UR - https://www.unboundmedicine.com/medline/citation/17233309/Neuroendoscopic_treatment_of_multiloculated_hydrocephalus_in_children_ L2 - https://thejns.org/doi/10.3171/ped.2007.106.1.29 DB - PRIME DP - Unbound Medicine ER -