Computer-assisted stereotactic third ventriculostomy in the management of noncommunicating hydrocephalus.
Between January, 1984, and December, 1990, a total of 85 patients have undergone stereotactic third ventriculostomy (TV) at the Mayo Clinic. Sixty-one patients (74%) presented with mass lesions in the region of the posterior third ventricle, aqueduct of Sylvius or fourth ventricle. Twenty-four patients (26%) presented with non-tumoral, adult/adolescent-onset aqueductal stenosis. Follow-up was available for all 85 patients and ranged from 1 to 66 months (mean 25 months). Follow-up revealed initial patency in 84 patients. Eleven patients (13%) ultimately required extracranial shunting for persistent symptomatic hydrocephalus. Two patients underwent revision of their TV. Twenty-seven patients had been previously shunted. Of these, 23 (85%) have remained asymptomatic after TV without the need for further shunting. Stereotactic TV is a safe and effective way of re-establishing normal cerebrospinal fluid flow dynamics in selected cases of obstructive hydrocephalus.
Dalrymple
S J
SJ
Department of Neurologic Surgery, Mayo Clinic, Rochester, Minn.
Kelly
P J
PJ
D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000145:classification / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D013238:Stereotaxic Techniques; D013813:Therapy, Computer-Assisted; D014696:Ventriculostomy