Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2020; 8(14): 3039-3049
Published online Jul 26, 2020. doi: 10.12998/wjcc.v8.i14.3039
Endoscopic third ventriculostomy in obstructive hydrocephalus: A case report and analysis of operative technique
Matic Munda, Peter Spazzapan, Roman Bosnjak, Tomaz Velnar
Matic Munda, Peter Spazzapan, Roman Bosnjak, Tomaz Velnar, Department of Neurosurgery, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
Tomaz Velnar, AMEU-ECM Maribor, Ljubljana 1000, Slovenia
Author contributions: Munda M and Velnar T designed the study; Bosnak R and Spazzapan P performed the research; Bosnjak R supervised the manuscript; Munda M wrote the manuscript; Velnar T, Spazzapan P and Bosnjak R revised the manuscript.
Informed consent statement: Patient signed the informed consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Tomaz Velnar, MD, PhD, Assistant Professor, Doctor, Department of Neurosurgery, University Medical Centre Ljubljana, Zaloska 7, Ljubljana 1000, Slovenia. tvelnar@hotmail.com
Received: March 27, 2020
Peer-review started: March 27, 2020
First decision: April 24, 2020
Revised: May 25, 2020
Accepted: July 14, 2020
Article in press: July 14, 2020
Published online: July 26, 2020
Processing time: 119 Days and 5.8 Hours
Abstract
BACKGROUND

The endoscopic third ventriculostomy (ETV) is a neuroendoscopical procedure that represents a more suitable alternative to the extracranial shunting. It consists of fenestrating the floor of the third ventricle and thus establishing a free flow of the cerebrospinal fluid from the ventricles to the site of resorption in the subarachnoid space. It offers a more physiological solution and a chance at a shunt-free life for children with hydrocephalus. The main indication for the procedure is obstructive hydrocephalus, however, it can also be useful in patients with other forms of hydrocephalus.

CASE SUMMARY

We present a treatment flow of a 9-year-old patient, diagnosed with an obstructive hydrocephalus due to tectal glioma that was successfully treated with an ETV. We review the important factors influencing the success rate such as age, aetiology, shunt history, preoperative planning and visualisation of the basilar artery.

CONCLUSION

Even though the ETV effectively controls obstructive hydrocephalus in more than 75% of all cases, the overall success rate of the procedure varies and could be approved by the correct preoperative patient selection.

Keywords: Endoscopic third ventriculostomy; Neuroendoscopy; Hydrocephalus; Case report

Core tip: The endoscopic third ventriculostomy (ETV) is a suitable alternative to extracranial shunting in obstructive hydrocephalus. It consists of fenestrating the third ventricle floor, thus establishing a free flow of cerebrospinal fluid from the ventricles to the subarachnoid space. It offers a chance for a shunt-free life in children with hydrocephalus. We present a treatment flow of a 9-year-old patient diagnosed with obstructive hydrocephalus due to tectal glioma that was successfully treated with an ETV and review the obstructive hydrocephalus pathology.