title: Management of Pyogenic Cerebral Ventriculitis by Neuroendoscopic Surgery.
abstract: BACKGROUND
  Pyogenic cerebral ventriculitis is a debilitating form of intracranial infection with an unfavorable outcome as a result of lack of experience in surgical management.
  
  
  OBJECTIVE
  To study retrospectively a group of pyogenic cerebral ventriculitis patients managed by neuroendoscopic surgery (NES).
  
  
  METHODS
  The standard intraventricular protocols of NES to treat this disease included 1 or more of the following: 1) obliteration of debris, 2) evidence of microbial infection, 3) septomy, 4) incision of the septation, or 5) monitoring catheter insertion. Modified external ventricular drainage EVD (mEVD) was combined with NES when intraventricular debris and bacterial plaques could not be evacuated completely. Subsequent surgical treatment strategies depended on the clinical manifestation, cerebrospinal fluid analysis, and mEVD blockage tests approximately 3 weeks after the last NES.
  
  
  RESULTS
  Forty-one patients, who were distributed in 7 hospitals and underwent NES, were included. Five patients received 1 NES, 18 received 2, 16 received 3, and 2 received 4. mEVD was performed in all patients, and mean mEVD duration in the hospital was 27.6 days. At discharge, 15 patients were cured, 15 were cured but ventriculoperitoneal shunt dependent, 9 were mEVD dependent, and 2 died (mean modified Rankin Scale score was 2.48). Two mEVD-dependent patients died, and no other outcomes changed during postoperative follow-up (mean modified Rankin Scale score, 2.67).
  
  
  CONCLUSIONS
  The results suggest a relatively favorable outcome for management of pyogenic cerebral ventriculitis by NES. The techniques and strategies are practical and should be applied more extensively.
authors.affiliation: Second Department of Neurosurgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Wang
authors.affiliation: Second Department of Neurosurgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
authors.forename: Xiao-Yan
authors.initials: XY
authors.lastname: Yao
authors.affiliation: Department of Anatomy, Histology and Embryology, Kunming Medical University, Kunming, China.
authors.forename: Zhi-Rong
authors.initials: ZR
authors.lastname: Zou
authors.affiliation: Second Department of Neurosurgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
authors.forename: Hua-Lin
authors.initials: HL
authors.lastname: Yu
authors.affiliation: Second Department of Neurosurgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China. Electronic address: styrsyj@163.com.
authors.forename: Tao
authors.initials: T
authors.lastname: Sun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D058565:Cerebral Ventriculitis / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy / Q000379:methods*; D059906:Neuroimaging; D012189:Retrospective Studies; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt / Q000379:methods*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Neuroendoscopy; Prognosis; Surgery; Ventriculitis