title: Post-traumatic hydrocephalus is a contraindication for endoscopic third-ventriculostomy: isn't it?
abstract: OBJECTIVE
  Post-traumatic hydrocephalus (PTH) is commonly considered as a relative contraindication for endoscopic third-ventriculostomy (ETV). However, few studies are available on this topic.
  
  
  METHODS
  An analysis of the papers published in the last ten years has been performed, in order to assess the level of evidence on which the current indication for ETV for PTH is based. References were identified by PubMed searches of clinical articles relating to both PTH and ETV. Laboratory investigations were excluded.
  
  
  RESULTS
  Only 5 articles were selected, for a total of 15 patients with PTH treated with ETV. All these patients were described by the authors to have a communicating hydrocephalus. No complications of surgery were reported. Outcome data were not available for one patient. Thirteen out of the remaining 14 patients had a clinical improvement after the surgical procedure (93%). Direct or indirect information on pre-operative ICP was available for 11 cases. Eight of them had an elevated ICP and presented a clinical improvement after ETV.
  
  
  CONCLUSIONS
  There is no current evidence to support that PTH is a contraindication for ETV. Our data suggest that we could reconsider ETV for the treatment of PTH, especially for patients with elevated ICP. Prospective clinical trials (involving several centers, due to the difficulty of recruiting patients with PTH) are needed.
authors.affiliation: Institute of Neurosurgery, Catholic University School of Medicine, Largo F. Vito 1, 00168 Rome, Italy. debonisvox@gmail.com
authors.forename: Pasquale
authors.initials: P
authors.lastname: De Bonis
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Tamburrini
authors.forename: Annunziato
authors.initials: A
authors.lastname: Mangiola
authors.forename: Angelo
authors.initials: A
authors.lastname: Pompucci
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Mattogno
authors.forename: Manuela
authors.initials: M
authors.lastname: Porso
authors.forename: Carmelo
authors.initials: C
authors.lastname: Anile
mesh_terms: D000818:Animals; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000601:surgery*; D007427:Intracranial Pressure / Q000502:physiology; D011446:Prospective Studies; D020542:Third Ventricle / Q000601:surgery*; D016896:Treatment Outcome; D014696:Ventriculostomy / Q000009:adverse effects / Q000379:methods