Complications of Endoscopic Third Ventriculostomy and Strategies for Avoiding Them : An Analysis of 100 Cases(<SPECIAL ISSUES>Neuroendoscopy)

Abstract

To assess the complications related to endoscopic third ventriculostomy (ETV) and the strategies for avoiding them, a retrospective analysis of 100 consecutive ETVs performed between 1997 and 2007 was conducted. The patient ages ranged between 1 day and 69 years. The overall success rate was 73%. We experienced 7 complications (one case of arterial bleeding from basilar artery or its branch, two intraventricular hemorrhages, one case of diabetes insipidus, and one case of septic meningitis) in 6 cases. There were no cases of permanent morbidity or death. All 6 cases with complications were hydrocephalus in the pediatric population and 4 of them were under 1 year of age. In one patient case suffering from a serious vascular injury, perforation of the floor of the third ventricle was performed utilizing an electrode probe. Accordingly, our strategies to avoid the vascular complications are as follows : 1) do not use an electrode probe for ETV ; 2) careful placement of the sheath and irrigation with lactated Ringer's solution, which may play an essential role for intraoperative management of vascular injuries.