Post-traumatic hydrocephalus is a contraindication for endoscopic third-ventriculostomy: Isn’t it?

Abstract Objectives Post-traumatic hydrocephalus (PTH) is commonly considered as a relative contraindication for endoscopic third-ventriculostomy (ETV). However, few studies are available on this topic. Methods An analysis of the papers published in the last ten years has been performed, in order to...

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Bibliographic Details
Published in:Clinical neurology and neurosurgery 2013-01, Vol.115 (1), p.9-12
Main Authors: De Bonis, Pasquale, Tamburrini, Gianpiero, Mangiola, Annunziato, Pompucci, Angelo, Mattogno, Pier Paolo, Porso, Manuela, Anile, Carmelo
Format: Article
Language:English
Subjects:
Animals
Biological and medical sciences
Brain damage
Compliance
Endoscopic third ventriculostomy
Hemorrhage
Humans
Hydrocephalus - diagnosis
Hydrocephalus - surgery
Infections
Intracranial Pressure - physiology
Medical sciences
Mortality
Neurology
Neurosurgery
Outcome
Post-traumatic hydrocephalus
Prospective Studies
Review
Shunt responders
Success
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Third Ventricle - surgery
Treatment Outcome
Ventriculostomy - adverse effects
Ventriculostomy - methods
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Summary:Abstract Objectives Post-traumatic hydrocephalus (PTH) is commonly considered as a relative contraindication for endoscopic third-ventriculostomy (ETV). However, few studies are available on this topic. Methods An analysis of the papers published in the last ten years has been performed, in order to assess the level of evidence on which the current indication for ETV for PTH is based. References were identified by PubMed searches of clinical articles relating to both PTH and ETV. Laboratory investigations were excluded. Results Only 5 articles were selected, for a total of 15 patients with PTH treated with ETV. All these patients were described by the authors to have a communicating hydrocephalus. No complications of surgery were reported. Outcome data were not available for one patient. Thirteen out of the remaining 14 patients had a clinical improvement after the surgical procedure (93%). Direct or indirect information on pre-operative ICP was available for 11 cases. Eight of them had an elevated ICP and presented a clinical improvement after ETV. Conclusions There is no current evidence to support that PTH is a contraindication for ETV. Our data suggest that we could reconsider ETV for the treatment of PTH, especially for patients with elevated ICP. Prospective clinical trials (involving several centers, due to the difficulty of recruiting patients with PTH) are needed.
ISSN:0303-8467
1872-6968
DOI:10.1016/j.clineuro.2012.08.021