title: Endoscopic third ventriculostomy in the management of hydrocephalus: Outcome analysis of 168 consecutive procedures.
abstract: BACKGROUND
  Endoscopic third ventriculostomy (ETV) is the treatment of choice for obstructive hydrocephalus, but the outcome is still controversial in terms of age and aetiology.
  
  
  METHODS
  Between 1998 and 2011, 168 consecutive procedures were performed in 164 patients, primarily children (56%<18 years of age and 35%<2 years of age). The causes of obstructive hydrocephalus included tumoural pathology, Chiari malformation, congenital obstruction of the aqueduct, post-infectious and post-haemorrhagic membranes, and ventriculo-peritoneal shunt (VPS) malfunctions. Successful ETV was defined by the resolution of symptoms and the avoidance of a shunt.
  
  
  RESULTS
  ETV was successful in 75.6% of patients, but 19% of the patients required VPS in the first month after ETV, and 5.4% required a VPS more than one month after ETV. Four patients were ultimately submitted for second ETVs. In this series, no major permanent morbidity or mortality was observed.
  
  
  CONCLUSIONS
  ETV is a safe procedure and an effective treatment for obstructive hydrocephalus even following the dysfunction of previous VPSs and in children younger than two years.
authors.affiliation: Department of Neurosurgery, Centro Hospitalar São João, Oporto, Portugal; Neurosciences Unity, CUF Porto Hospital, Oporto, Portugal; Faculty of Medicine, University of Porto, Oporto, Portugal; Faculty of Health Sciencs, University of Lúrio, Nampula, Mozambique. Electronic address: sfsalvador.neurocirurgia@gmail.com.
authors.forename: Sérgio F
authors.initials: SF
authors.lastname: Salvador
authors.affiliation: Department of Neurosurgery, Centro Hospitalar São João, Oporto, Portugal; Faculty of Medicine, University of Porto, Oporto, Portugal. Electronic address: jago79@gmail.com.
authors.forename: Joana
authors.initials: J
authors.lastname: Oliveira
authors.affiliation: Department of Neurosurgery, Centro Hospitalar São João, Oporto, Portugal; Neurosciences Unity, CUF Porto Hospital, Oporto, Portugal; Faculty of Medicine, University of Porto, Oporto, Portugal. Electronic address: josuepereira@sapo.pt.
authors.forename: Josué
authors.initials: J
authors.lastname: Pereira
authors.affiliation: Faculty of Medicine, University of Porto, Oporto, Portugal; Institute of Public Health, University of Porto, Oporto, Portugal. Electronic address: henriquepbarros@gmail.com.
authors.forename: Henrique
authors.initials: H
authors.lastname: Barros
authors.affiliation: Department of Neurosurgery, Centro Hospitalar São João, Oporto, Portugal; Neurosciences Unity, CUF Porto Hospital, Oporto, Portugal; Faculty of Medicine, University of Porto, Oporto, Portugal. Electronic address: ruimcvaz@gmail.com.
authors.forename: Rui
authors.initials: R
authors.lastname: Vaz
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D007223:Infant; D008297:Male; D044583:Neuroendoscopy / Q000379:methods* / Q000706:statistics & numerical data; D020542:Third Ventricle / Q000601:surgery*; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt / Q000379:methods / Q000706:statistics & numerical data; D014696:Ventriculostomy / Q000379:methods* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Endoscopic third ventriculostomy; Hydrocephalus; Ventriculocisternostomy