title: Experience with Lumbar Puncture Following Endoscopic Third Ventriculostomy for Obstructive Hydrocephalus.
abstract: Background and ObjectiveThe increase in intracranial pressure (ICP) in some patients in the immediate postoperative period following endoscopic third ventriculostomy (ETV) is not well understood. This study explored the effect of lumbar puncture following ETV for obstructive hydrocephalus on outcome.Materials and MethodsA total of 145 patients with obstructive hydrocephalus underwent ETV between 2009 and 2014. Following ETV, all patients underwent lumbar puncture on postoperative days 1 and 3.ResultsIn 106 patients, ICP returned to normal levels accompanied by symptom relief. In 39 patients, ICP remained high on postoperative days 3, and lumbar puncture was continued every alternate postoperative day for 11 days. ICP always returned to normal. These 39 patients were divided into two groups for analysis: group A (age < 18 years) and group B (age ≥ 18 years). Peak values of ICP for groups A and B were recorded on days 3 and 5, respectively.ConclusionsOur study suggests an important role for postoperative lumbar puncture in ensuring successful treatment results after ETV. In most of the symptomatic patients with obstructive hydrocephalus, lumbar puncture appears to contribute to rapid ICP normalization, to alleviation of symptoms, and prevention of complications.
authors.affiliation: Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Hu
authors.affiliation: Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
authors.forename: Zhuang
authors.initials: Z
authors.lastname: Kang
authors.affiliation: Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
authors.forename: Guangtong
authors.initials: G
authors.lastname: Zhu
authors.affiliation: Department of Neuroscience, The Prince of Wales Hospital, University of New South Wales, Sydney, Australia.
authors.forename: Jian
authors.initials: J
authors.lastname: Tu
authors.affiliation: Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Huang
authors.affiliation: Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Guan
authors.affiliation: Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Dai
authors.affiliation: Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
authors.forename: Beibei
authors.initials: B
authors.lastname: Mao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D007223:Infant; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy / Q000379:methods*; D011182:Postoperative Care; D011184:Postoperative Period; D013129:Spinal Puncture / Q000379:methods*; D020542:Third Ventricle / Q000601:surgery*; D016896:Treatment Outcome; D014696:Ventriculostomy / Q000379:methods*; D055815:Young Adult