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Endoscopic Techniques in the Management of Hydrocephalus

Did you know that incidence of congenital hydrocephalus is 3 per 1,000 live births?

What is Hydrocephalus?

Hydrocephalus is caused by disturbance of formation, flow, or absorption of cerebrospinal fluid (CSF) that leads to an increase in volume occupied by this fluid in the central nervous system. There are two major types of hydrocephalus:

1.     Communicating – includes CSF over-production (idiopathic or due to choroid plexus tumors) or less CSF absorption at level of sub-arachnoid space and arachnoid villi due to hemorrhage or neonatal meningitis

2.     Non-communicating (obstructive) – caused by CSF flow obstruction due to idiopathic aqueductal stenosis, brain tumors (pineal, tectal, brainstem, fourth ventricle), infection, hemorrhage or congenital cysts

How can the Division of Neurosurgery at Cardinal Glennon help your patients with hydrocephalus?

Minimally-invasive neuro-endoscopy techniques performed by the Cardinal Glennon neurosurgery team can be used to treat selected pediatric patients with hydrocephalus, reducing pain, blood loss, scarring and recovery time. 

Endoscopic third ventriculostomy (ETV)

Endoscopic third ventriculostomy (ETV) is a minimally-invasive neuro-endoscopy procedure that has become well accepted as a standard treatment option for selected patients with symptomatic obstructive hydrocephalus and established as an alternative to both initial ventriculoperitoneal (VP) or ventriculoatrial (VA) shunt implantation and to revision of a failed shunt. ETV’s indications can also be expanded to include certain cases of communicating hydrocephalus. Multiple studies looking at complications, long term ETV success and risk factors for failure in both adult and pediatric populations have suggest outcomes comparable or better than shunting.

In select patients with obstructive hydrocephalus, ETV as an alternative to permanent shunting can avoid the high risk of complications related to shunting. Ventricular shunts have up to 80% lifetime risk of complications and 10% infection rate, mostly in the first year after implantation. Average life of a shunt is about 6-8 years.

Division Director of Neurosurgery at Cardinal Glennon and Assistant Professor of Neurosurgery at Saint Louis University School of Medicine Samer Elbabaa, MD, is available 24/7 to community physicians, surgical specialists and patients. All referrals and questions are welcome. To reach Dr. Elbabaa: 314-577-5306 or selbabaa@slu.edu 

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