ULTRASOUND-GUIDED ENDOSCOPIC FENESTRATION OF THE 3RD VENTRICULAR FLOOR FOR NONCOMMUNICATING HYDROCEPHALUS

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.