title: Redo third ventriculostomy.
abstract: BACKGROUND
  Endoscopic third ventriculostomy (ETV) is the treatment of choice for obstructive hydrocephalus. In some cases a reclosure of the ventriculostoma occurs. This could be caused by different reasons, such as operative technique, size of the stoma, scarring, or a persisting Liliequist membrane.
  
  
  METHODS
  The databases of the Neurosurgical Department of the Philipps University Marburg and the International Neuroscience Institute Hannover have been explored. The medical reports of patients who suffered from hydrocephalus and were treated with ETV between 1990 and 2010 were reviewed, with special consideration of a nonpatent ventriculostoma and a repeated ETV.
  
  
  RESULTS
  Of 148 patients with ETV, we had 14 patients in whom the stoma was not patent. In 8 of those, we performed a successful second ventriculostomy. Five patients were treated with application of a ventriculoperitoneal shunt. One patient died of an acute obstructive hydrocephalus due to the closure of the ventriculostoma. The success rate of repeat ETV has been 87.5%.
  
  
  CONCLUSIONS
  In cases of secondary closure of the stoma after ETV, an endoscopic reventriculostomy is recommended using the same operative approach and should be taken into consideration before the application of a cerebrospinal fluid diversion system.
authors.affiliation: International Neuroscience Institute, Hannover, Germany. hellwig@ini-hannover.de
authors.forename: Dieter
authors.initials: D
authors.lastname: Hellwig
authors.forename: Mario
authors.initials: M
authors.lastname: Giordano
authors.forename: Christoph
authors.initials: C
authors.lastname: Kappus
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000473:pathology / Q000601:surgery*; D007427:Intracranial Pressure / Q000502:physiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy / Q000379:methods; D010347:Patient Care Planning; D012008:Recurrence; D012086:Reoperation; D020542:Third Ventricle / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D014696:Ventriculostomy / Q000379:methods*; D055815:Young Adult