A. Rieger et al., ULTRASOUND-GUIDED ENDOSCOPIC FENESTRATION OF THE 3RD VENTRICULAR FLOOR FOR NONCOMMUNICATING HYDROCEPHALUS, Minimally invasive neurosurgery, 39(1), 1996, pp. 17-20
Conventional valve shunting for treatment of hydrocephalus has a high
rate of long-term complications. Endoscopic ventriculostomy by fenestr
ation of the third ventricular floor, a minimally-invasive technique,
avoids many of the drawbacks of extracranial shunting. Endoscopy was p
erformed in 12 hydrocephalic patients with MRI-diagnosed aqueductal st
enosis and neurological signs. Intraoperative ultrasound guidance allo
wed aiming the tip of the rigid endoscope to the foramen of Monro, and
direct entering of the enlarged third ventricle. This technique is as
exact as stereotaxy but is faster and easier. No complications were s
een due to the surgical procedure. Nine patients were cured from their
complaints, in 3 cases there was a subjective improvement of neurolog
y. Long-term patency of the third ventriculostomy was confirmed by mov
ement-sensitive MRI.