title: Results of endoscopic third ventriculostomy in elderly patients ≥65 years of age.
abstract: BACKGROUND
  Endoscopic third ventriculostomy (ETV) has been accepted as the procedure of choice for the treatment of obstructive hydrocephalus in children and adults. The role and outcome of this procedure in the elderly has not been evaluated yet.
  
  
  METHODS
  Over an 11-year interval we retrospectively analyzed data of patients, 65+ years of age, who underwent ETV in our center. Success of the procedure was assessed in terms of symptom relief and/or elimination of the need for shunting. Additionally pre- and postoperative ventricular volumes were estimated using Evan's index (Ei) and fronto-occipital horn ratio (FOR). In our analysis we compared the results of the elderly patients with those of the pediatric and adult age groups treated in our center.
  
  
  RESULTS
  We obtained data of 16 elderly cases (11 males, 5 females), mean age 72.8 years (66-83 years) out of the 91 patients treated with ETV in total. The success rate was 75% in this age group; mean follow-up 18.4 months (2-55 months). In 10 patients a mass lesion was the underlying cause of hydrocephalus. Mean ventricular size reduction was 18% and 13.5% (Ei and FOR) in the success group vs. 7.6% and 6.2% in the failure group. Three out of four patients who had shunting pre-EVT, became shunt independent post-operatively. The presence of flow void over the stoma was 100% correlated with success. All 7 patients with a primary or metastatic brain tumor were able to receive radiation therapy.
  
  
  CONCLUSIONS
  Also in elderly, ETV is a safe and efficient procedure, with success rates similar to the younger population. Further research is required to set up a prognostic scoring system for this age group.
authors.affiliation: Department of Neurosurgery, University Hospitals Leuven, Herestraat 49, Leuven 3000, Belgium. Electronic address: hamidreza.niknejad@uzleuven.be.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Niknejad
authors.affiliation: Department of Neurosurgery, University Hospitals Leuven, Herestraat 49, Leuven 3000, Belgium. Electronic address: bart.depreitere@uzleuven.be.
authors.forename: Bart
authors.initials: B
authors.lastname: Depreitere
authors.affiliation: Department of Neurosurgery, University Hospitals Leuven, Herestraat 49, Leuven 3000, Belgium. Electronic address: steven.devleeschouwer@uzleuven.be.
authors.forename: Steven
authors.initials: S
authors.lastname: De Vleeschouwer
authors.affiliation: Department of Neurosurgery, University Hospitals Leuven, Herestraat 49, Leuven 3000, Belgium. Electronic address: frank.vancalenbergh@uzleuven.be.
authors.forename: Frank
authors.initials: F
authors.lastname: Van Calenbergh
authors.affiliation: Department of Neurosurgery, University Hospitals Leuven, Herestraat 49, Leuven 3000, Belgium. Electronic address: johannes.vanloon@uzleuven.be.
authors.forename: Johannes
authors.initials: J
authors.lastname: van Loon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D008297:Male; D044583:Neuroendoscopy / Q000379:methods; D012189:Retrospective Studies; D020542:Third Ventricle / Q000601:surgery*; D016896:Treatment Outcome; D014696:Ventriculostomy / Q000379:methods
keywords: Elderly; Endoscopic third ventriculostomy; Hydrocephalus