Neuroendoscopic third ventriculostomy for hydrocephalus in adults: Report of a single unit's experience with 63 cases

BACKGROUND Neuroendoscopic third ventriculostomy (NTV) is becoming a first line treatment for hydrocephalus in this center. Its use in a consecutive s eries of adults is reported. METHOD Initially a retrospective data collection after 7 months becoming pr ospective studying all patients who underwent NTV in this center. The adult s (17 years or older) have been studied. RESULTS Sixty-three patients met the criteria for inclusion: 38 male, 25 fe male. Mean age at first NTV 37.5 years. There was an 80% success rate (i.e. , no further therapy for the hydrocephalus required). Follow-up was for a m ean of 3.1 years. The largest subgroup were patients with third ventricular tumours (35%), of whom 86% were successfully treated. Mean time to failure for the whole series was 8.5 months (range immediate-30 months). Complicat ions occurred in 17.5%; those deemed serious in 11%. There were three death s (4.7%) within 30 days of the procedure. There were six other deaths durin g follow-up, five because of tumour progression and one because of pneumoni a. CONCLUSIONS This procedure lends itself to the treatment of hydrocephalus i n adults and appears to be more successful than in young children. It is ef ficacious in both previously shunted and non shunted patients. It is now th e first-line treatment for noncommunicating hydrocephalus in this center an d also for patients with shunt failure who are anatomically suitable, havin g cerebrospinal fluid spaces large enough to admit the endoscope. The compl ication and mortality rates compare favorably with those for shunts. (C) 20 01 by Elsevier Science Inc.