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Changes in intracranial CSF distribution after ETV

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Abstract

Objective

The aim of this prospective study was to analyze the changes in cerebrospinal fluid (CSF) distribution after endoscopic third ventriculocisternostomy (ETV).

Methods

Twenty-two hydrocephalic children (eight boys, aged 3 months to 17 years) candidates for ETV were studied by preoperative brain magnetic resonance (MR) and repeated post-ETV MRs at established time intervals. A volumetric analysis of CSF distribution after ETV was performed using a specific software.

Results

Fifteen children had an uneventful follow-up, whereas four required a second ETV due to a secondary closure of the stoma, one died of acute intracranial hypertension, and two needed an extrathecal shunt. A progressive reduction in the volume of the ventricles was found in case of successful ETV during the follow-up period. The ventricular volumes were reduced in average of 76 % of the initial volume at day 3, 69 % at 2 weeks, 42 % at 2 months, and 40 % at 6 months. This finding was associated with an enlargement of subarachnoid spaces which increased in case of successful ETV (192 % of initial volume at day 3; 210 % at day 15; 428 % at 2 months; and 468 % at 6 months). In case of secondary closure of the stoma, the distribution of intra- and extraventricular CSF tended to go back to the preoperative status.

Conclusion

Volume variations of the ventricles and the subarachnoid spaces are a good indicator of the efficacy of the ETV.

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Authors and Affiliations

  1. Department of Paediatric Neurosurgery, Necker Enfants Malades Hospital, 156 rue de Vaugirard, 75015, Paris, France

    Federico Di Rocco, Stephanie Puget, Thomas Roujeau, Thomas Blauwblomme, Michel Zerah & Christian Sainte-Rose

  2. Department of Neuroradiology, Necker Enfants Malades Hospital, Paris, France

    David Grevent, Nathalie Boddaert & Francis Brunelle

  3. René Descartes University, Paris 5, France

    David Grevent, Nathalie Boddaert, Stephanie Puget, Thomas Roujeau, Thomas Blauwblomme, Michel Zerah, Francis Brunelle & Christian Sainte-Rose

  4. Division of Neurosurgery, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada

    James M. Drake

Authors
  1. Federico Di Rocco
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  2. David Grevent
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  3. James M. Drake
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  4. Nathalie Boddaert
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  5. Stephanie Puget
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  6. Thomas Roujeau
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  7. Thomas Blauwblomme
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  8. Michel Zerah
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  9. Francis Brunelle
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  10. Christian Sainte-Rose
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Corresponding author

Correspondence to Christian Sainte-Rose.

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Di Rocco, F., Grevent, D., Drake, J.M. et al. Changes in intracranial CSF distribution after ETV. Childs Nerv Syst 28, 997–1002 (2012). https://doi.org/10.1007/s00381-012-1752-6

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  • DOI: https://doi.org/10.1007/s00381-012-1752-6

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