Download PDF
CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2024; 43(04): e237-e244
DOI: 10.1055/s-0044-1793955
Original Article

Endoscopic Septostomy for Treatment of Complex Hydrocephalus: A Single Center Retrospective Cohort

Septostomia Endoscópica para tratamento da Hidrocefalia Complexa: Uma coorte retrospectiva de um único centro
Gerson Evandro Perondi
1   Department of Neurosurgery, Cristo Redentor Hospital, Porto Alegre, RS, Brazil
,
Luciano Silveira Basso
1   Department of Neurosurgery, Cristo Redentor Hospital, Porto Alegre, RS, Brazil
,
Deborah Lumi Shuha
1   Department of Neurosurgery, Cristo Redentor Hospital, Porto Alegre, RS, Brazil
,
Rafaela Jucá Lindner 
2   School of Medicine, Universidade do Vale do Rio dos Sinos, São Leopoldo, RS, Brazil
,
Marcelo Anchieta Rohde
2   School of Medicine, Universidade do Vale do Rio dos Sinos, São Leopoldo, RS, Brazil
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Objective The objective was to present the initial experience with endoscopic septostomy in a Brazilian public hospital.

Methods A retrospective analysis was conducted on patients who underwent neuroendoscopic septostomy at the Department of Neurosurgery of Cristo Redentor Hospital in Porto Alegre from 2015 to 2021.

Results In the period analyzed, 14 patients underwent endoscopic septostomy. The mean age of the patients was 41.86 years; 11 were male and 3 were female. The etiologies of hydrocephalus included ventricular inflammatory conditions, neoplasms, neurocysticercosis, and intraventricular cysts. Following septostomy, 64% of the patients exhibited clinical and radiological improvement. Complications occurred in 29% of the cases, including intraventricular hemorrhage and thalamic contusion. Four deaths were observed, all related to clinical complications or progression of the underlying disease.

Conclusion Endoscopic septostomy is an effective and safe procedure for treating complex hydrocephalus of different etiologies. Surgical outcomes are related to the learning curve with neuroendoscopy, and the benefits for patients are evident, considering the possibility of safely and effectively performing simultaneous endoscopic procedures with septostomy.

Resumo

Objetivo O objetivo foi apresentar a experiência inicial com septostomia endoscópica em um hospital público brasileiro.

Métodos Uma análise retrospectiva foi conduzida em pacientes submetidos à septostomia neuroendoscópica no Departamento de Neurocirurgia do Hospital Cristo Redentor em Porto Alegre, de 2015 a 2021.

Resultados No período analisado, 14 pacientes foram submetidos à septostomia endoscópica. A média de idade dos pacientes foi de 41,86 anos; 11 eram do sexo masculino e 3 do sexo feminino. As etiologias da hidrocefalia incluíram condições inflamatórias ventriculares, neoplasias, neurocisticercose e cistos intraventriculares. Após a septostomia, 64% dos pacientes apresentaram melhora clínica e radiológica. Complicações ocorreram em 29% dos casos, incluindo hemorragia intraventricular e contusão talâmica. Quatro óbitos foram observados, todos relacionados a complicações clínicas ou à progressão da doença subjacente.

Conclusão A septostomia endoscópica é um procedimento eficaz e seguro para o tratamento da hidrocefalia complexa de diferentes etiologias. Os resultados cirúrgicos estão relacionados à curva de aprendizado com a neuroendoscopia, e os benefícios para os pacientes são evidentes, considerando a possibilidade de realizar procedimentos endoscópicos simultâneos com a septostomia de maneira segura e eficaz.

Keywords

neuroendoscopy - hydrocephalus - Foramen of Monro - septum pellucidum

Palavras-chave

neuroendoscopia - hidrocefalia - Forame de Monro - septo pelúcido


Publication History

Received: 04 July 2024

Accepted: 18 October 2024

Article published online:
18 November 2024

© 2024. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 Boyar B, Ildan F, Bagdatoglu H, Cetinalp E, Karadayi A. Unilateral hydrocephalus resulting from occlusion of foramen of Monro: a new procedure in the treatment: stereotactic fenestration of the septum pellucidum. Surg Neurol 1993; 39 (02) 110-114
    CrossrefPubMedSearch in Google Scholar
  • 2 Black PM, Levine BW, Picard EH, Nirmel K. Asymmetrical hydrocephalus following ventriculitis from rupture of a thalamic abscess. Surg Neurol 1983; 19 (06) 524-527
    CrossrefPubMedSearch in Google Scholar
  • 3 Siqueira EB, Richardson RR, Kranzler LI. Cysticercosis cerebri occluding the foramen of Monro. Surg Neurol 1980; 13 (06) 429-431
    PubMedSearch in Google Scholar
  • 4 Tien R, Harsh IV GR, Dillon WP, Wilson CB. Unilateral hydrocephalus caused by an intraventricular venous malformation obstructing the foramen of Monro. Neurosurgery 1990; 26 (04) 664-666
    CrossrefPubMedSearch in Google Scholar
  • 5 Abasolo VS. Neuroendoscopia Cerebral Infantile. Indicaciones. Tec Actuales Em Neurocir EndoscópicaEdiciones Guadalupe. 2007
    Search in Google Scholar
  • 6 Bognar L, Markia B, Novak L. Retrospective analysis of 400 neuroendoscopic interventions: the Hungarian experience. Neurosurg Focus 2005; 19 (06) E10
    CrossrefPubMedSearch in Google Scholar
  • 7 Fritsch MJ, Kienke S, Ankermann T, Padoin M, Mehdorn HM. Endoscopic third ventriculostomy in infants. J Neurosurg 2005; 103 (01) 50-53
    PubMedSearch in Google Scholar
  • 8 Valenzuela Abásolo S. Neuroendoscopía. Rev Chil Neurocir 1998; 12 (n.esp): 9-14
    PubMedSearch in Google Scholar
  • 9 Grunert P, Charalampaki P, Hopf N, Filippi R. The role of third ventriculostomy in the management of obstructive hydrocephalus. Minim Invasive Neurosurg 2003; 46 (01) 16-21
    Thieme ConnectPubMedSearch in Google Scholar
  • 10 Hellwig D, Grotenhuis JA, Tirakotai W. et al. Endoscopic third ventriculostomy for obstructive hydrocephalus. Neurosurg Rev 2005; 28 (01) 1-34 , discussion 35–38
    PubMedSearch in Google Scholar
  • 11 Jallo GI, Kothbauer KF, Abbott IR. Endoscopic third ventriculostomy. Neurosurg Focus 2005; 19 (06) E11
    CrossrefPubMedSearch in Google Scholar
  • 12 Oertel JMK, Schroeder HWS, Gaab MR. Third Ventriculostomy for Treatment of Hydrocephalus: Results of 271 Procedures. Neurosurg Q 2006; 16 (01) 24-31
    CrossrefPubMedSearch in Google Scholar
  • 13 Vinas FC, Castillo C, Diaz FG. Microanatomical considerations for the fenestration of the septum pellucidum. Minim Invasive Neurosurg 1998; 41 (01) 20-26
    Thieme ConnectPubMedSearch in Google Scholar
  • 14 Charles T. Endoscopic for the Treatment of Hydrocephalus. In: Endoscopy of the central and peripheral nervous system. Thieme medical publishers; 1998
    Search in Google Scholar
  • 15 Aldana PR, Kestle JRW, Brockmeyer DL, Walker ML. Results of endoscopic septal fenestration in the treatment of isolated ventricular hydrocephalus. Pediatr Neurosurg 2003; 38 (06) 286-294
    CrossrefPubMedSearch in Google Scholar
  • 16 Walker M. Ventricular Endoscopy: Pitfalls, considerations and complications. In: Endoscopy of the central and peripheral nervous system. Thieme medical publishers;; 1998
    Search in Google Scholar
  • 17 Segal S. Endoscopic Anatomy of the Ventricular System. In: Endoscopy of the central and peripheral nervous system. Thieme medical publishers;; 1998
    Search in Google Scholar
  • 18 Gangemi M, Maiuri F, Donati PA, Signorelli F, Basile D. Endoscopic surgery for monoventricular hydrocephalus. Surg Neurol 1999; 52 (03) 246-250 , discussion 250–251
    CrossrefPubMedSearch in Google Scholar
  • 19 Schroeder HWS, Oertel J, Gaab MR. Endoscopic treatment of cerebrospinal fluid pathway obstructions. Neurosurgery 2007; 60 (2, Suppl 1) ONS44-ONS51 , discussion ONS51–ONS52
    PubMedSearch in Google Scholar
  • 20 Giammattei L, Aureli V, Daniel RT, Messerer M. Neuroendoscopic septostomy: Indications and surgical technique. Neurochirurgie 2018; 64 (03) 190-193
    CrossrefPubMedSearch in Google Scholar
  • 21 SLAGTER. Ron. Drawing Coronal section of the brain - no labels. AnatomyTOOL.org. Available at: https://anatomytool.org/content/slagter-drawing-coronal-section-brain-no-labels . License: Creative Commons Attribution-NonCommercial-ShareAlike. Accessed: Accessed: June 16, 2024.
    PubMed
  • 22 Tamburrini G, Frassanito P, Massimi L, Caldarelli M, Di Rocco C. Endoscopic septostomy through a standard precoronal ventricular access: feasibility and effectiveness. Acta Neurochir (Wien) 2012; 154 (08) 1517-1522
    CrossrefPubMedSearch in Google Scholar
  • 23 Oppido PA, Fiorindi A, Benvenuti L. et al. Neuroendoscopic biopsy of ventricular tumors: a multicentric experience. Neurosurg Focus 2011; 30 (04) E2
    CrossrefPubMedSearch in Google Scholar
  • 24 Atchley TJ, Sowers B, Arynchyna AA, Rozzelle CJ, Rocque BG. Complications of neuroendoscopic septostomy. J Neurosurg Pediatr 2021; 29 (02) 185-191
    CrossrefPubMedSearch in Google Scholar
  • 25 Wei Q, Xu Y, Peng K. et al. Value of the Application of Neuroendoscope in the Treatment of Ventriculoperitoneal Shunt Blockage. World Neurosurg 2018; 116: e469-e475
    CrossrefPubMedSearch in Google Scholar
  • 26 Hamada H, Hayashi N, Kurimoto M, Umemura K, Hirashima Y, Endo S. Neuroendoscopic septostomy for isolated lateral ventricle. Neurol Med Chir (Tokyo) 2003; 43 (12) 582-587 , discussion 588
    CrossrefPubMedSearch in Google Scholar