Endoscopic third ventriculostomy in children younger than 2 years of age.
BACKGROUND
Endoscopic third ventriculostomy (ETV) for the treatment of hydrocephalus of different etiologies is still controversial in children younger than 2 years of age. The success rate of ETV in this group of patients is analyzed in this study.


METHODS
The series consisted of 21 patients treated with ETV. The mean age of the patients was 6.7 months, ranging from 9 days to 15 months (16 patients were younger than 1 year). The study included hydrocephalus due to idiopathic aqueductal stenosis (eight) and other congenital anomalies (four) as well as posthemorrhagic (three) and tumor-related occlusive hydrocephalus (three). Two patients presented with shunt infection and one with a shunt failure. ETV was considered to be successful when shunting could be avoided.


RESULTS
ETV was successful in nine patients, with a mean follow-up period of 26.2 months. The procedure was successful in four patients with idiopathic aqueductal stenosis, in two with other congenital anomalies, in one posthemorrhagic, and in two with a tumor-related hydrocephalus. In 12 patients, the ETV was unsuccessful after a mean follow-up of 3.3 months. These patients required a shunt. Ten of them were less than 1 year old when ETV was performed. In one tumor-related hydrocephalus, a shunt was inserted after a meningitis after tumor removal.


CONCLUSIONS
The success of ETV in children younger than 2 years of age suffering from non-communicating hydrocephalus seems to be dependent on both age and etiology. Our results show an overall success rate of 43%. In 37.5% of the children younger than 1 year of age, ETV was successful. ETV in patients with hydrocephalus due to idiopathic aqueductal stenosis seems to be more beneficial than in other causes of hydrocephalus.
Baldauf
Jörg
J
Department of Neurosurgery, Ernst-Moritz-Arndt University, Sauerbruchstrasse, 17475, Greifswald, Germany.
Oertel
J
J
Gaab
Michael R
MR
Schroeder
Henry W S
HW
D000367:Age Factors; D002535:Cerebral Aqueduct / Q000473:pathology / Q000601:surgery; D002557:Cerebrospinal Fluid Shunts / Q000379:methods; D003251:Constriction, Pathologic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D007223:Infant; D008297:Male; D044583:Neuroendoscopy / Q000379:methods*; D020542:Third Ventricle / Q000601:surgery*; D017211:Treatment Failure; D016896:Treatment Outcome; D014696:Ventriculostomy / Q000379:methods*