Application of endoscopic third ventriculostomy for treating hydrocephalus-correlated Chiari type I malformation in a single Chinese neurosurgery centre.
The correlation between hydrocephalus and Chiari type I malformation (CIM) has been debated since Chiari's first descriptions of CIM but some studies have shown that CIM and hydrocephalus (HCP) could cause symptoms/disease of each other or vice versa. Recent research has found that treatment focused on hydrocephalus with ventricle enlargement also provides alleviation of CIM and even of syringomyelia. However, the lack of consensus among previous studies left unanswered the question of how endoscopic third ventriculostomy (ETV) addresses CIM and why it fails. Ten symptomatic hydrocephalic patients associated with CIM underwent ETV from October 2002 to May 2012. The clinical features and neuroimaging of all patients were reviewed. Statistical analysis was applied to evaluate the changes in the tonsillar ectopia and the ventricle dilation after operation. The mean follow-up period of this series was 92 months (range 24-163 months). Eight patients (80%) remained shunt free or experienced symptom relief following ETV. The remaining two patients were identified as failures due to the deterioration of symptoms or subsequent hindbrain decompression. Endoscopic third ventriculostomy provides an effective treatment for hydrocephalus associated with CIM, which can relieve HCP and improve the symptoms of CIM in most patients. The clinical outcomes are related to the major cause of the tonsillar herniation.
Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.|Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.|Beijing Institute for Brain Disorders Brain Tumor Center|, Beijing, China.|China National Clinical Research Center for Neurological Diseases, Beijing, China.|Department of Neurosurgery, Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China.
Yiping
Y
Wu
Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.|Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.|Beijing Institute for Brain Disorders Brain Tumor Center|, Beijing, China.|China National Clinical Research Center for Neurological Diseases, Beijing, China.
Chuzhong
C
Li
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Xuyi
X
Zong
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Xinsheng
X
Wang
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Songbai
S
Gui
Department of Neurosurgery, Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China.
Caiping
C
Gu
Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. zyz2004520@yeah.net.|Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. zyz2004520@yeah.net.|Beijing Institute for Brain Disorders Brain Tumor Center|, Beijing, China. zyz2004520@yeah.net.|China National Clinical Research Center for Neurological Diseases, Beijing, China. zyz2004520@yeah.net.
Yazhuo
Y
Zhang
D000293:Adolescent; D000328:Adult; D001139:Arnold-Chiari Malformation / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D044466:Asian People; D002648:Child; D002681:China; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D007223:Infant; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy; D059906:Neuroimaging; D020542:Third Ventricle / Q000601:surgery*; D016896:Treatment Outcome; D014696:Ventriculostomy / Q000379:methods
Chiari type I malformation; Endoscopic third ventriculostomy; Hydrocephalus; Tonsillar herniation