ENDOSCOPIC IIIr VENTRICULOSTOMY IN THE TREATMENT OF HYDROCEPHALUS

Endoscopic ventriculostomy of the third ventricle floor consists in making an opening in the floor of the third ventricle to allow free flow of cerebrospinal fluid to be absorbed by the choroid plexus.


Ventriculostomy of the third ventricle floor	Diagram of endoscopic ventriculostomy of the third ventricle floor


Endoscopic view of the third ventricle floor	Endoscopic view after perforating the floor of the third ventricle

It is suggested for the treatment of obstructive hydrocephalus (not communicating). It is however not indicated for communicating hydrocephalus, but can be done in specific cases (e.g. if there is a shunt infection and you want to remove it while the infection is removed). In children under two years of age the success rate of endoscopic III ventriculostomy is low (although it depends on the anatomy of the ventricles and cause of hydrocephalus), so many neurosurgeons prefer not to carry it out. If you hold the endoscopic ventriculostomy in this age group, the complication rate is higher than if the valve is implanted drain, but if successful, the procedure eliminates the need for a drain valve and the risks associated with the malfunctioning of the same. Even with ETV success from the beginning, it remains important for the child to go to regular reviews with us.

Endoscopic ventriculostomy is an important alternative for the derivation of obstructive hydrocephalus in older children and adults. It is an individual decision for each case to make a ventriculostomy or to insert a shunt.


MRI in sagittal section of obstructive hydrocephalus secondary to pineal region tumor	MR image in coronal section of obstructive hydrocephalus secondary to pineal region tumor

MRI in sagittal endoscopic ventriculostomy for obstructive hydrocephalus secondary to pineal region tumor	MR image in coronal endoscopic ventriculostomy for obstructive hydrocephalus secondary to pineal region tumor

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