The Results of Neuroendoscopic Surgery in Patients with Posttraumatic and Posthemorrhagic Hydrocephalus

CHRASTINA, Jan, Zdeněk NOVÁK, Tomáš ZEMAN, Věra FEITOVÁ, Dušan HRABOVSKÝ and Ivo ŘÍHA. The Results of Neuroendoscopic Surgery in Patients with Posttraumatic and Posthemorrhagic Hydrocephalus. WORLD NEUROSURGERY. NEW YORK: ELSEVIER SCIENCE INC, 2018, vol. 113, MAY 2018, p. "E113"-"E121", 9 pp. ISSN 1878-8750. Available from: https://dx.doi.org/10.1016/j.wneu.2018.01.186.

Basic information

• Original name: The Results of Neuroendoscopic Surgery in Patients with Posttraumatic and Posthemorrhagic Hydrocephalus
• Authors: CHRASTINA, Jan (203 Czech Republic, guarantor, belonging to the institution), Zdeněk NOVÁK (203 Czech Republic, belonging to the institution), Tomáš ZEMAN (203 Czech Republic, belonging to the institution), Věra FEITOVÁ (203 Czech Republic), Dušan HRABOVSKÝ (703 Slovakia, belonging to the institution) and Ivo ŘÍHA (203 Czech Republic, belonging to the institution).
• Edition: WORLD NEUROSURGERY, NEW YORK, ELSEVIER SCIENCE INC, 2018, 1878-8750.

Other information

• Original language: English
• Type of outcome: Article in a journal
• Field of Study: 30210 Clinical neurology
• Country of publisher: United States of America
• Confidentiality degree: is not subject to a state or trade secret
• Impact factor: Impact factor: 1.723
• RIV identification code: RIV/00216224:14110/18:00103955
• Organization unit: Faculty of Medicine
• Doi: http://dx.doi.org/10.1016/j.wneu.2018.01.186
• UT WoS: 000432942700016
• Keywords in English: Endoscopic third ventriculostomy; Hydrodynamic theory; Neuroendoscopy; Posthemorrhagic hydrocephalus; Posttraumatic hydrocephalus
• Tags: 14110119, 14110131, rivok
• Tags: International impact, Reviewed

Abstract

BACKGROUND: Posttraumatic hydrocephalus (PTH) and posthemorrhagic hydrocephalus (PHH) were previously considered not suitable for neuroendoscopic treatment. New hydrocephalus theories support possible successful neuroendoscopy in such patients. METHODS: This study presents the results of neuroendoscopy in PTH and PHH with a background analysis. From 130 hydrocephalic patients after neuroendoscopic surgeries, 35 cases with PTH (n = 11) or PHH (n = 24; acute: n = 9, subacute: n = 10, chronic: n = 5) were found. The success rate (Glasgow Outcome Scale [GOS] score 4 or 5 without shunt) and clinical outcome (GOS score) of endoscopic third ventriculostomy (ETV) were analyzed. During the study period, 34 patients had ventriculoperitoneal shunts implanted, including 2 PTH and 5 PHH patients (all chronic). RESULTS: The success rate of ETV in PTH was 54.5%. In acute PHH, the success rate was 33.3%, 42.8% after excluding devastating hematomas. A post-ETV shunt was implanted in 1 patient (massive subarachnoid hemorrhage [SAH]) with final GOS score of 5. In subacute cases, the ETV success rate was 40% (no post-ETV shunts). In chronic PHH, only 1 patient with a GOS score of 5 was shunt-free (20%). The cause of ETV failure was massive SAH. Low final GOS score was caused by the extent of intracerebral bleeding or extracranial problems. The main indications for primary shunt implantation in PTH and PHH were infectious complications. The rate of good outcomes was 0% in PTH and 40% in PHH. CONCLUSIONS: The best results of neuroendoscopy were achieved in PTH and acute PHH. ETV failures were associated with massive SAH; arachnoid cistern blockage and scarring precludes ETV success.