Radiological Parameters of Success of Endoscopic Third Ventriculostomy

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Mostafa Zein
Hassan I El Shafei
Ahmed Sayed
Ahmed Mohamed Alselisly
Ahmed Hamdy Ali Haggag


Endoscopic third ventriculostomy, obstructive hydrocephalus, ventricular size, third ventricle


Introduction: Endoscopic third ventriculostomy (ETV) is becoming the procedure of choice in the treatment of obstructive hydrocephalus.
Aim: Determine radiological parameters of success of ETV and changes in ventricular size that occur after an effective ETV and how these changes related to clinical outcome.
Material and methods: Forty eight patients with obstructive hydrocephalus surgically treated with ETV were prospectively studied with assessment of the results based on clinical and radiological criteria. Ventricular size was measured with the Evans index, third ventricle index and cella media index. , age ranged from 2-64 years, and the mean age was 22.46 years.
Results: The overall success rate was 77 % (37 of the 48 cases) while failure occurred in 11 cases, ventricular size diminishes moderately after a clinically successful ETV especially when measured by Evans ratio which exhibits the greatest variability post-operative with a mean reduction of 60%.
Conclusions: Ventricular size diminishes moderately after a successful endoscopic third ventriculostomy. The importance of ventricular size changes is very much secondary to the clinical status. This reduction is more prominent in acute forms of hydrocephalus than in chronic ones. Evans ratio provides more valuable information in assessment of ventricular size; it exhibits the greatest reduction post-operative.

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