title: Effectiveness of neuroendoscopic ventricular irrigation for ventriculitis.
abstract: OBJECTIVE
  Ventriculitis is an uncommon condition with a poor prognosis, especially when complicated by brain abscess. We compared the therapeutic efficacy of neuroendoscopic ventricular irrigation with those of conventional treatments such as ventricular drainage and continuous irrigation via a ventricular drain.
  
  
  METHODS
  We retrospectively analyzed 14 consecutive patients treated for ventriculitis at our institution between 2001 and 2015. Included were the six patients treated with neuroendoscopic (NE) irrigation (NE group), which we adopted in 2011, and the eight patients treated before 2011 with conventional treatments (non-NE group). We compared mortality, modified Rankin Scale (mRS) score 6 months postoperatively, and duration of ventricular/spinal drainage-catheter placement between groups.
  
  
  RESULTS
  Mean age at onset was 49.3 years (range, 32-68 years) in the NE group and 50.3 years (range, 8-78 years) in the non-NE group. At 6-month follow-up, good clinical outcome (mRS≤3) was observed in 66.7% of the NE group, whereas it was observed in 25.0% of the non-NE group. There were three deaths (37.5%) in the non-NE group but none in the NE group. Duration of drainage-catheter placement was significantly shorter in the NE group than in the non-NE group (19.8days vs. 70.9days, p<0.001). Among patients in the NE group, only those who underwent irrigation on the day of diagnosis maintained a low mRS score.
  
  
  CONCLUSIONS
  Neuroendoscopic ventricular irrigation was safe and effective in the treatment of ventriculitis. Immediate intervention after diagnosis may lead to an improved prognosis.
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Yukie
authors.initials: Y
authors.lastname: Terada
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan. Electronic address: mineharu@kuhp.kyoto-u.ac.jp.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Mineharu
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Arakawa
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Funaki
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tanji
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Miyamoto
mesh_terms: D000328:Adult; D000368:Aged; D058565:Cerebral Ventriculitis / Q000628:therapy*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy / Q000379:methods*; D017063:Outcome Assessment, Health Care; D007507:Therapeutic Irrigation / Q000379:methods*
keywords: Abscess; Irrigation; Neuroendoscopy; Ventriculitis