Endoscopic third ventriculostomy in patients with cerebrospinal fluid infection and/or hemorrhage

Vitaly Siomin, Giuseppe Cinalli, Andre Grotenhuis, Aprajay Golash, Shizuo Oi, Karl Kothbauer, Howard Weiner, Jonathan Roth, Liana Beni-Adani, Alain Pierre-Kahn, Yasuhiro Takahashi, Connor Mallucci, Ira Richmond Abbott, III, Jeffrey Wisoff, Shlomi Constantini

Research output: Contribution to journalArticle

164 Citations (Scopus)

Abstract

Object. In this study the authors evaluate the safety, efficacy, and indications for endoscopic third ventriculostomy (ETV) in patients with a history of subarachnoid hemorrhage or intraventricular hemorrhage (IVH) and/or cerebrospinal fluid (CSF) infection. Methods. The charts of 101 patients from seven international medical centers were retrospectively reviewed; 46 patients had a history of hemorrhage, 42 had a history of CSF infection, and 13 had a history of both disorders. All patients experienced third ventricular hydrocephalus before endoscopy. The success rate for treatment in these three groups was 60.9, 64.3, and 23.1%, respectively. The follow-up period in successfully treated patients ranged from 0.6 to 10 years. Relatively minor complications were observed in 15 patients (14.9%), and there were no deaths. A higher rate of treatment failure was associated with three factors: classification in the combined infection/hemorrhage group, premature birth in the posthemorrhage group, and younger age in the postinfection group. A higher success rate was associated with a history of ventriculoperitoneal (VP) shunt placement before ETV in the posthemorrhage group, even among those who had been born prematurely, who were otherwise more prone to treatment failure. The 13 premature infants who had suffered an IVH and who had undergone VP shunt placement before ETV had a 100% success rate. The procedure was also successful in nine of 10 patients with primary aqueductal stenosis. Conclusions. Patients with obstructive hydrocephalus and a history of either hemorrhage or infection may be good candidates for ETV, with safety and success rates comparable with those in more general series of patients. Patients who have sustained both hemorrhage and infection are poor candidates for ETV, except in selected cases and as a treatment of last resort. In patients who have previously undergone shunt placement posthemorrhage, ETV is highly successful. It is also highly successful in patients with primary aqueductal stenosis, even in those with a history of hemorrhage or CSF infection.

Original languageEnglish (US)
Pages (from-to)519-524
Number of pages6
JournalJournal of Neurosurgery
Volume97
Issue number3
StatePublished - Sep 2002
Externally publishedYes

Fingerprint

Ventriculostomy
Cerebrospinal Fluid
Hemorrhage
Infection
Hydrocephalus
Ventriculoperitoneal Shunt
Treatment Failure
Safety
Premature Birth
Subarachnoid Hemorrhage
Premature Infants
Endoscopy

Keywords

  • Endoscopic third ventriculostomy
  • Hemorrhage
  • Hydrocephalus
  • Infection
  • Premature infant

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Siomin, V., Cinalli, G., Grotenhuis, A., Golash, A., Oi, S., Kothbauer, K., ... Constantini, S. (2002). Endoscopic third ventriculostomy in patients with cerebrospinal fluid infection and/or hemorrhage. Journal of Neurosurgery, 97(3), 519-524.

Endoscopic third ventriculostomy in patients with cerebrospinal fluid infection and/or hemorrhage. / Siomin, Vitaly; Cinalli, Giuseppe; Grotenhuis, Andre; Golash, Aprajay; Oi, Shizuo; Kothbauer, Karl; Weiner, Howard; Roth, Jonathan; Beni-Adani, Liana; Pierre-Kahn, Alain; Takahashi, Yasuhiro; Mallucci, Connor; Abbott, III, Ira Richmond; Wisoff, Jeffrey; Constantini, Shlomi.

In: Journal of Neurosurgery, Vol. 97, No. 3, 09.2002, p. 519-524.

Research output: Contribution to journalArticle

Siomin, V, Cinalli, G, Grotenhuis, A, Golash, A, Oi, S, Kothbauer, K, Weiner, H, Roth, J, Beni-Adani, L, Pierre-Kahn, A, Takahashi, Y, Mallucci, C, Abbott, III, IR, Wisoff, J & Constantini, S 2002, 'Endoscopic third ventriculostomy in patients with cerebrospinal fluid infection and/or hemorrhage', Journal of Neurosurgery, vol. 97, no. 3, pp. 519-524.
Siomin V, Cinalli G, Grotenhuis A, Golash A, Oi S, Kothbauer K et al. Endoscopic third ventriculostomy in patients with cerebrospinal fluid infection and/or hemorrhage. Journal of Neurosurgery. 2002 Sep;97(3):519-524.
Siomin, Vitaly ; Cinalli, Giuseppe ; Grotenhuis, Andre ; Golash, Aprajay ; Oi, Shizuo ; Kothbauer, Karl ; Weiner, Howard ; Roth, Jonathan ; Beni-Adani, Liana ; Pierre-Kahn, Alain ; Takahashi, Yasuhiro ; Mallucci, Connor ; Abbott, III, Ira Richmond ; Wisoff, Jeffrey ; Constantini, Shlomi. / Endoscopic third ventriculostomy in patients with cerebrospinal fluid infection and/or hemorrhage. In: Journal of Neurosurgery. 2002 ; Vol. 97, No. 3. pp. 519-524.
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abstract = "Object. In this study the authors evaluate the safety, efficacy, and indications for endoscopic third ventriculostomy (ETV) in patients with a history of subarachnoid hemorrhage or intraventricular hemorrhage (IVH) and/or cerebrospinal fluid (CSF) infection. Methods. The charts of 101 patients from seven international medical centers were retrospectively reviewed; 46 patients had a history of hemorrhage, 42 had a history of CSF infection, and 13 had a history of both disorders. All patients experienced third ventricular hydrocephalus before endoscopy. The success rate for treatment in these three groups was 60.9, 64.3, and 23.1{\%}, respectively. The follow-up period in successfully treated patients ranged from 0.6 to 10 years. Relatively minor complications were observed in 15 patients (14.9{\%}), and there were no deaths. A higher rate of treatment failure was associated with three factors: classification in the combined infection/hemorrhage group, premature birth in the posthemorrhage group, and younger age in the postinfection group. A higher success rate was associated with a history of ventriculoperitoneal (VP) shunt placement before ETV in the posthemorrhage group, even among those who had been born prematurely, who were otherwise more prone to treatment failure. The 13 premature infants who had suffered an IVH and who had undergone VP shunt placement before ETV had a 100{\%} success rate. The procedure was also successful in nine of 10 patients with primary aqueductal stenosis. Conclusions. Patients with obstructive hydrocephalus and a history of either hemorrhage or infection may be good candidates for ETV, with safety and success rates comparable with those in more general series of patients. Patients who have sustained both hemorrhage and infection are poor candidates for ETV, except in selected cases and as a treatment of last resort. In patients who have previously undergone shunt placement posthemorrhage, ETV is highly successful. It is also highly successful in patients with primary aqueductal stenosis, even in those with a history of hemorrhage or CSF infection.",
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AU - Golash, Aprajay

AU - Oi, Shizuo

AU - Kothbauer, Karl

AU - Weiner, Howard

AU - Roth, Jonathan

AU - Beni-Adani, Liana

AU - Pierre-Kahn, Alain

AU - Takahashi, Yasuhiro

AU - Mallucci, Connor

AU - Abbott, III, Ira Richmond

AU - Wisoff, Jeffrey

AU - Constantini, Shlomi

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N2 - Object. In this study the authors evaluate the safety, efficacy, and indications for endoscopic third ventriculostomy (ETV) in patients with a history of subarachnoid hemorrhage or intraventricular hemorrhage (IVH) and/or cerebrospinal fluid (CSF) infection. Methods. The charts of 101 patients from seven international medical centers were retrospectively reviewed; 46 patients had a history of hemorrhage, 42 had a history of CSF infection, and 13 had a history of both disorders. All patients experienced third ventricular hydrocephalus before endoscopy. The success rate for treatment in these three groups was 60.9, 64.3, and 23.1%, respectively. The follow-up period in successfully treated patients ranged from 0.6 to 10 years. Relatively minor complications were observed in 15 patients (14.9%), and there were no deaths. A higher rate of treatment failure was associated with three factors: classification in the combined infection/hemorrhage group, premature birth in the posthemorrhage group, and younger age in the postinfection group. A higher success rate was associated with a history of ventriculoperitoneal (VP) shunt placement before ETV in the posthemorrhage group, even among those who had been born prematurely, who were otherwise more prone to treatment failure. The 13 premature infants who had suffered an IVH and who had undergone VP shunt placement before ETV had a 100% success rate. The procedure was also successful in nine of 10 patients with primary aqueductal stenosis. Conclusions. Patients with obstructive hydrocephalus and a history of either hemorrhage or infection may be good candidates for ETV, with safety and success rates comparable with those in more general series of patients. Patients who have sustained both hemorrhage and infection are poor candidates for ETV, except in selected cases and as a treatment of last resort. In patients who have previously undergone shunt placement posthemorrhage, ETV is highly successful. It is also highly successful in patients with primary aqueductal stenosis, even in those with a history of hemorrhage or CSF infection.

AB - Object. In this study the authors evaluate the safety, efficacy, and indications for endoscopic third ventriculostomy (ETV) in patients with a history of subarachnoid hemorrhage or intraventricular hemorrhage (IVH) and/or cerebrospinal fluid (CSF) infection. Methods. The charts of 101 patients from seven international medical centers were retrospectively reviewed; 46 patients had a history of hemorrhage, 42 had a history of CSF infection, and 13 had a history of both disorders. All patients experienced third ventricular hydrocephalus before endoscopy. The success rate for treatment in these three groups was 60.9, 64.3, and 23.1%, respectively. The follow-up period in successfully treated patients ranged from 0.6 to 10 years. Relatively minor complications were observed in 15 patients (14.9%), and there were no deaths. A higher rate of treatment failure was associated with three factors: classification in the combined infection/hemorrhage group, premature birth in the posthemorrhage group, and younger age in the postinfection group. A higher success rate was associated with a history of ventriculoperitoneal (VP) shunt placement before ETV in the posthemorrhage group, even among those who had been born prematurely, who were otherwise more prone to treatment failure. The 13 premature infants who had suffered an IVH and who had undergone VP shunt placement before ETV had a 100% success rate. The procedure was also successful in nine of 10 patients with primary aqueductal stenosis. Conclusions. Patients with obstructive hydrocephalus and a history of either hemorrhage or infection may be good candidates for ETV, with safety and success rates comparable with those in more general series of patients. Patients who have sustained both hemorrhage and infection are poor candidates for ETV, except in selected cases and as a treatment of last resort. In patients who have previously undergone shunt placement posthemorrhage, ETV is highly successful. It is also highly successful in patients with primary aqueductal stenosis, even in those with a history of hemorrhage or CSF infection.

KW - Endoscopic third ventriculostomy

KW - Hemorrhage

KW - Hydrocephalus

KW - Infection

KW - Premature infant

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