Third ventriculocisternostomy in cerebellar haematomas.
BACKGROUND
We prospectively evaluated the role of endoscopic third ventriculocisternostomy in the management of acute obstructive hydrocephalus created by cerebellar hematomas.


METHODS
Following a therapeutic diagram based on clinical and radiological signs, endoscopic third ventriculocisternostomy was used to treat hydrocephalus associated with cerebellar hematomas in 8 patients (male: 5, female: 3, mean age: 67 years-old). Causes of cerebellar hemorrhage were spontaneous in 6 cases, traumatic in 1 case, and acute bleeding of a posterior fossa tumor (lung metastasis) in the remaining case. Deeply comatose patients (Glasgow Coma Score between 3 and 5) and patients with signs of brainstem compression were initially excluded from this study.


RESULTS
Overall clinical improvement after third ventriculocisternostomy was achieved in all patients and was associated with the decrease of the ventricle size on follow-up CT scans. One patient who initially had a clot evacuation associated with an external ventricular drainage and persistant hydrocephalus had a successful third ventriculocisternostomy in the post operative course. No complication related to the procedure was noted.


CONCLUSIONS
In selected patients, third ventriculocisternostomy can be used to treat hydrocephalus associated with posterior fossa hematomas.
Roux
F-E
FE
Department of Adult and Pediatric Neurosurgery, Hôpital Purpan, Toulouse, France.
Boetto
S
S
Tremoulet
M
M
D000368:Aged; D000369:Aged, 80 and over; D002531:Cerebellum / Q000473:pathology / Q000601:surgery*; D005260:Female; D020199:Hematoma, Subdural, Acute / Q000473:pathology / Q000601:surgery*; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011446:Prospective Studies; D020542:Third Ventricle / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014696:Ventriculostomy / Q000379:methods*