Late rapid deterioration after endoscopic third ventriculostomy: additional cases and review of the literature

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Publication Type Journal Article
School or College School of Medicine
Department Neurosurgery
Creator Kestle, John R. W.
Other Author Drake, James; Chumas, Paul; Pierre-Kahn, Alain; Vinchon, Matthieu; Brown, Jennifer; Pollack, Ian F.; Arai, Hajime
Title Late rapid deterioration after endoscopic third ventriculostomy: additional cases and review of the literature
Date 2006
Description Object. Late rapid deterioration after endoscopic third ventriculostomy (ETV) is a rare complication. The authors previously reported three deaths from three centers. Three other deaths and a patient who experienced rapid deterioration have also been reported. Following the death at the University of Toronto of an additional patient who underwent surgery elsewhere, they canvassed pediatric neurosurgeons in North America, Europe, Australia, and Asia for additional cases. Methods. An email was sent to the members of the Canadian Congress of Neurological Sciences who are pediatric neurosurgeons, to the pediatric neurosurgery email list of the American Association of Neurological Surgeons, to the email list of the International Society for Pediatric Neurosurgery, and to designated neurosurgeons in the United Kingdom, France, Japan, Korea, Taiwan, and Australia, who in turn contacted pediatric neurosurgeons in their countries. A data form was provided, and data from previously reported cases were extracted. Nine additional cases were identified, and the results were collated with those of the seven cases previously reported. Patient age at surgery ranged from 2 days to 13 years (mean 7.6 years). The most common causes of hydrocephalus were aqueductal stenosis in 50% of patients and tectal glioma in 25% of patients. The time to treatment failure ranged from 5 weeks to 7.8 years (mean 2.5 years). Thirteen patients died, one patient was in a vegetative state, one patient was mildly disabled, and one patient whose condition deteriorated outside the operating room was alive and well. In the 13 patients in whom the ventriculostomy site was visualized at autopsy or repeated endoscopy, the ventriculostomy was shown to be occluded. Conclusions. Late rapid deterioration is a rare but lethal complication of ETV. The mechanism is unclear, but deterioration can occur long after the ETV becomes occluded. Patients and caregivers should be counseled regarding this potential complication. An indwelling ventricular access device is an option for patients undergoing ETV.
Type Text
Publisher American Association of Neurological Surgeons (AANS)
Volume 105
First Page 118
Last Page 126
Subject Endoscopic third ventriculostomy; ETV; Pediatric neurosurgery; Adverse outcome
Subject LCSH Hydrocephalus in children; Pediatric neurology
Dissertation Institution University of Utah
Language eng
Bibliographic Citation Drake, J., Chumas, P., Kestle, J. R. W., Pierre-Kahn, A., Vinchon, M., Brown, J., Pollack, I. F., & Arai, H. (2006). Late rapid deterioration after endoscopic third ventriculostomy: additional cases and review of the literature. Journal of Neurosurgery, 105, 118-26.
Rights Management (c) American Association of Neurological Surgeons
Format Medium application/pdf
Format Extent 678,684 bytes
Identifier ir-main,13203
ARK ark:/87278/s6kd2g5q
Setname ir_uspace
Date Created 2012-06-13
Date Modified 2013-02-01
ID 703677
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