Romanian Neurosurgery (Dec 2023)
Endoscopic third ventriculostomy in post traumatic hydrocephalus
Abstract
Background: Hydrocephalus is a known sequelae in traumatic brain injury patients. It may occur early or late and presents with dementia, urinary incontinence and difficulty in walking. There are two distinct types of normal pressure hydrocephalus one is idiopathic most commonly seen in the elderly age groups and the other is secondary due to a CerebroVascular Accident, trauma or surgery. The idiopathic type may not respond to the cerebrospinal fluid diversion procedure, but the secondary type responds to the cerebrospinal fluid diversion procedure. Our study aims at exploring the option of Endoscopic third ventriculostomy in these patients not making them shunt dependent. Materials and methods: The patients with traumatic brain injury admitted to the department of neurosurgery between January 2012 and January 2018 were included in the study. Congenital hydrocephalus and secondary hydrocephalus due to spontaneous Sub arachnoid haemorrhage and tumours were excluded. 14 patients were identified and if there was some improvement in their condition after cerebrospinal fluid tap tests were planned for endoscopic third ventriculostomy. Results: Out of the 14 patients 2 were females and the remaining 12 were males. 2 did not improve at all. 12 had some improvement out of which 3 had a failure and underwent a ventriculo peritoneal shunt. Hence there were 5 failures out of 14 which made 35.7%. Conclusion: Endoscopic third ventriculostomy is an option which can be offered to patients with secondary hydrocephalus. The chances of failure though present the procedure is minimally invasive and improves cerebrospinal fluid dynamics.
