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Endoscopic third ventriculostomy for management of hydrocephalus associated with Chiari malformation type II in children

BACKGROUND: Hydrocephalus is commonly associated with Chiari malformation (CM) particularly CM type II. The traditional treatment of hydrocephalus in these patients has been cerebrospinal fluid diversion by shunts. Endoscopic third ventriculostomy (ETV) has emerged as an alternative procedure in the...

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Autores principales: El-Ghandour, Nasser M. F., Salama, Mohamed M, Ghoneim, Mohamed Adel, Attia, Ahmed M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10227113/
https://www.ncbi.nlm.nih.gov/pubmed/36700950
http://dx.doi.org/10.1007/s00381-023-05832-4
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author El-Ghandour, Nasser M. F.
Salama, Mohamed M
Ghoneim, Mohamed Adel
Attia, Ahmed M.
author_facet El-Ghandour, Nasser M. F.
Salama, Mohamed M
Ghoneim, Mohamed Adel
Attia, Ahmed M.
author_sort El-Ghandour, Nasser M. F.
collection PubMed
description BACKGROUND: Hydrocephalus is commonly associated with Chiari malformation (CM) particularly CM type II. The traditional treatment of hydrocephalus in these patients has been cerebrospinal fluid diversion by shunts. Endoscopic third ventriculostomy (ETV) has emerged as an alternative procedure in these patients. PURPOSE: Assessment of the clinical and radiological outcomes of ETV in the management of hydrocephalus in children with CM II. METHODS: This is a prospective study conducted on 18 patients with CM II associated with hydrocephalus admitted to Cairo University hospitals between January 2020 and June 2021. These patients had been managed surgically by ETV. Clinical outcome was assessed based on improvement of manifestations of increased intracranial pressure while radiological outcome was based on the findings of postoperative computed tomography. In cases with early failure, serial lumbar puncture (LP) was performed for 2 days. RESULTS: ETV was performed as a secondary procedure in 4 cases. The overall success rate of the procedure was 72%, and its success rate as a secondary procedure was 100%. Serial LP was effective in decreasing early failure in 44.4% of cases. Radiological regression of hydrocephalic changes was detected in 50% of the cases. CONCLUSION: ETV is an efficient and safe procedure in the treatment of hydrocephalus in children with Chiari malformation II, particularly when performed as a secondary procedure. Serial LP following the procedure increases the success rate in patients with early failure.
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spelling pubmed-102271132023-05-31 Endoscopic third ventriculostomy for management of hydrocephalus associated with Chiari malformation type II in children El-Ghandour, Nasser M. F. Salama, Mohamed M Ghoneim, Mohamed Adel Attia, Ahmed M. Childs Nerv Syst Original Article BACKGROUND: Hydrocephalus is commonly associated with Chiari malformation (CM) particularly CM type II. The traditional treatment of hydrocephalus in these patients has been cerebrospinal fluid diversion by shunts. Endoscopic third ventriculostomy (ETV) has emerged as an alternative procedure in these patients. PURPOSE: Assessment of the clinical and radiological outcomes of ETV in the management of hydrocephalus in children with CM II. METHODS: This is a prospective study conducted on 18 patients with CM II associated with hydrocephalus admitted to Cairo University hospitals between January 2020 and June 2021. These patients had been managed surgically by ETV. Clinical outcome was assessed based on improvement of manifestations of increased intracranial pressure while radiological outcome was based on the findings of postoperative computed tomography. In cases with early failure, serial lumbar puncture (LP) was performed for 2 days. RESULTS: ETV was performed as a secondary procedure in 4 cases. The overall success rate of the procedure was 72%, and its success rate as a secondary procedure was 100%. Serial LP was effective in decreasing early failure in 44.4% of cases. Radiological regression of hydrocephalic changes was detected in 50% of the cases. CONCLUSION: ETV is an efficient and safe procedure in the treatment of hydrocephalus in children with Chiari malformation II, particularly when performed as a secondary procedure. Serial LP following the procedure increases the success rate in patients with early failure. Springer Berlin Heidelberg 2023-01-26 2023 /pmc/articles/PMC10227113/ /pubmed/36700950 http://dx.doi.org/10.1007/s00381-023-05832-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
El-Ghandour, Nasser M. F.
Salama, Mohamed M
Ghoneim, Mohamed Adel
Attia, Ahmed M.
Endoscopic third ventriculostomy for management of hydrocephalus associated with Chiari malformation type II in children
title Endoscopic third ventriculostomy for management of hydrocephalus associated with Chiari malformation type II in children
title_full Endoscopic third ventriculostomy for management of hydrocephalus associated with Chiari malformation type II in children
title_fullStr Endoscopic third ventriculostomy for management of hydrocephalus associated with Chiari malformation type II in children
title_full_unstemmed Endoscopic third ventriculostomy for management of hydrocephalus associated with Chiari malformation type II in children
title_short Endoscopic third ventriculostomy for management of hydrocephalus associated with Chiari malformation type II in children
title_sort endoscopic third ventriculostomy for management of hydrocephalus associated with chiari malformation type ii in children
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10227113/
https://www.ncbi.nlm.nih.gov/pubmed/36700950
http://dx.doi.org/10.1007/s00381-023-05832-4
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