Endoscopic Third Ventriculostomy for Non-Tumor Obstructive Hydrocephalus in Children under Two Years of Age

The goal of this work is to report on the efficacy of endoscopic third ventriculostomy (ETV) for non-tumor obstructive hydrocephalus in children aged two years and below. In the period between June 2007 and December 2014, we had performed ETV in 30 patients with hydrocephalus from diverse etiologies. Among them were eight children aged two years or below. Clinical, radiological and outcome data of these children were retrospectively reviewed to assess ETV efficiency in this age group. Eight children (6 boys, 2 girls) with age range from 6 to 24 months (mean 12.5 months, median 15 months) suffering from non-tumor obstructive hydrocephalus underwent ETV as primary treatment. Seven patients (87.5%) were under two years and 3 had less than one year of age at the time of surgery. Macro crania, suture diastasis, scalp vein bulging and sunset gaze were the most common findings on physical examination. Computed tomography scanning was done in all patients but none had magnetic resonance imaging. Hydrocephalus was due to primary (congenital) aqueductal stenosis in all cases and was associated with myelomeningocele in one. ETV was successful in 7 (87.50%) cases but failed in one. Operation time varied from 28 to 35 minutes (mean 31.12 minutes, median 31.5 minutes). No intraoperative complication occurred. The child in whom ETV failed had postoperative CSF leak. No death related to procedure occurred. Hospital stay ranged from 2 to 4 days (mean, 2.87 days, median, 3 days). Follow up range was 5.5 to 86 months (0.46 to 7.16 years);mean, 59.14 months (4.92 years);median, 45.75 months (3.81 years).

Tumor Obstructive Hydrocephalus Treated with Endoscopic Third Ventriculostomy in Cameroon

The goal of this work was to report on a series of preoperative endoscopic third ventriculostomy (ETV) performed for obstructive hydrocephalus due to posterior fossa tumors. Eight patients underwent preoperative ETV prior to tumor biopsy or removal for obstructive hydrocephalus related to posterior fossa tumors. All patients underwent surgery in two steps;ETV followed a week later by tumor resection. Clinical, radiological and outcome data were retrospectively reviewed. Eight patients (6 males, 2 females) aged between 8 and 45 years (mean age 24.62 years) suffering from obstructive hydrocephalus due to posterior fossa tumors had ETV prior to tumor removal or biopsy. Five patients were adults while 3 were under 18 years. All patients complained of headaches, seven presented with symptoms of raised intracranial pressure or visual disturbances and four had vomiting or cerebellar disturbance. Computed tomography scan was done in all patients and magnetic resonance imaging in five. Complete tumor removal was achieved in 4 cases and partial removal or biopsy in the remaining 4. ETV was successful in 7 (87.50%) cases but failed in one. Two patients experienced intraoperative transitory bradycardia. Two postoperative complications occurred (one meningitis and one CSF leak). No death related to procedures occurred. The histological diagnosis were as follows: ependymoma (3), medulloblastoma (3), astrocytoma grade II (1) and pineoblastoma (1). Hospital stay ranged from 9 to 21 days (mean, 12.71 days). Follow up range was 4 months to 78.4 months (0.33 to 6.53 years;mean, 46.11 months (3.84 years);median, 41.2 months (3.43 years).