Publication year: 2012
Source: World Neurosurgery, Available online 10 February 2012
Pietro Spennato, Claudio Ruggiero, Ferdinando Aliberti, Anna Nastro, Giuseppe Mirone, ...
BackgroundEndoscopic third ventriculostomy (ETV) is the treatment of choice for non-communicating hydrocephalus. In the last decade, its routine use has taken place also in patients who have previously undergone shunt placement (secondary ETV).MethodsThe authors review the specific anatomy of ventricular system in patients presenting with shunt malfunction, the criteria for patients selection and the results of ETV performed as alternative of shunt revision in case of shunt malfunction or infection.Results and conclusionsThe success rate of secondary ETV in well selected cases is not different from primary ETV; it should be reasonable to offer all patients with blocked shunts and suitable anatomy indicating an obstructive cause, the opportunity of shunt independence regardless of the original cause of the hydrocephalus. Shunt infection should not be considered a contraindication to ETV, even if the success rate may be lower. Considering the higher complication rate and higher risk of intraoperative failure, secondary ETV should be performed by expert neuro-endoscopists.
Júlio Leonardo B. Pereira
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