title: Endoscopic third ventriculostomy for hydrocephalus associated with tectal gliomas.
abstract: OBJECTIVE
  Tectal gliomas are a distinct form of pediatric brainstem tumor that present in patients with symptoms related to increased intracranial pressure due to obstructive hydrocephalus. The natural history of these lesions is often uniquely indolent. Thus, initial surgical therapies are directed at treatment of hydrocephalus, usually with ventricular shunt placement. Recently, third ventriculostomy has been used in patients with tectal gliomas, both as an initial procedure and after shunt failures. In this report the authors review their experience with the treatment of hydrocephalus in patients with tectal gliomas.
  
  
  METHODS
  The authors reviewed 31 consecutive cases of tectal gliomas and compared the success rates of ventricular shunt placement with the success rates of endoscopic third ventriculostomy (ETV). Shunt placement procedures were associated with a significant number of malfunctions, and most patients required shunt revisions. The ETV procedure was attempted both as an initial treatment and after shunt malfunction. Overall, ETV was attempted in 18 patients and was performed successfully in all cases. At the time of follow-up evaluation, 16 patients (89%) were shunt free.
  
  
  CONCLUSIONS
  The authors found that ETV could be performed with good long-term success both as an initial treatment and after shunt failure. Overall, ETV was found to be superior to ventricular shunt placement in the management of hydrocephalus associated with tectal gliomas.
authors.affiliation: Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Khan W
authors.initials: KW
authors.lastname: Li
authors.forename: Chanland
authors.initials: C
authors.lastname: Roonprapunt
authors.forename: Herman C
authors.initials: HC
authors.lastname: Lawson
authors.forename: I Rick
authors.initials: IR
authors.lastname: Abbott
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Wisoff
authors.forename: Fred
authors.initials: F
authors.lastname: Epstein
authors.forename: George I
authors.initials: GI
authors.lastname: Jallo
mesh_terms: D000293:Adolescent; D000328:Adult; D020295:Brain Stem Neoplasms / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005910:Glioma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014696:Ventriculostomy / Q000379:methods*