Efficacy of endoscopic third ventriculostomy in old aged patients with normal pressure hydrocephalus

Publication date: Available online 23 October 2017 Source:Neurologia i Neurochirurgia Polska Author(s): Young Sill Kang, Eun-Kyung Park, Ju-Seong Kim, Dong-Seok Kim, Ulrich-Wilhelm Thomale, Kyu-Won Shim Normal pressure hydrocephalus (NPH) is a chronic disorder caused by interrupted CSF absorption or flow. Generally, shunt placement is first option for NPH treatment. Due to complications of ventriculo-peritoneal (VP) shunt placement, endoscopic third ventriculostomy (ETV) can be considered as an alternative treatment option. Here we report the efficacy of ETV especially in old aged patients with normal pressure hydrocephalus. Total 21 old aged patients with communicating hydrocephalus with opening pressure, measured via lumbar puncture, less than 20cm H2O underwent ETV. 15 patients had primary/idiopathic NPH and 6 patients had secondary NPH. All patients were studied with a MRI to observe the flow void at aqueduct and the fourth ventricle outflow. And all of them underwent ETV. In a group with peak velocity was higher than 5cm/s, nine patients (75%) were evaluated was ‘favorable’ and three of them (25%) was scored ‘poor’. In another group with peak velocity less than 5cm/s, three of them were scored ‘poor’ and two of them were scored ‘stable’. None of them was evaluated as ‘favorable’. We also evaluated the outcomes according to etiology: 12 patients (80% of the patients with primary NPH) were evaluated with ‘favorable’ after ETV treatment. Two ...
Source: Polish Journal of Neurology and Neurosurgery - Category: Neurosurgery Source Type: research