Minim Invasive Neurosurg 2002; 45(3): 158-163
DOI: 10.1055/s-2002-34350
Original Article
© Georg Thieme Verlag Stuttgart · New York

Re-Ventriculostomy for Treatment of Obstructive Hydrocephalus in Cases of Stoma Dysfunction

D.  Koch1 , P.  Grunert1 , R.  Filippi1 , N.  Hopf1
  • 1Department of Neurosurgery, Johannes Gutenberg University, Mainz
Further Information

Publication History

Publication Date:
26 September 2002 (online)

Abstract

In this article, 12 re-ventriculostomies in the treatment for obstructive hydrocephalus are described. The etiology of the hydrocephalus was a benign aqueductal stenosis in 9 patients, a tumor around the aqueduct in 2 patients and intraventricular bleeding in one patient. In all cases the initial ventriculostomy was successful, but after a time interval of 2 weeks to 6 years the patients developed similar clinical symptoms as preoperatively. In all except one case the radiological findings spoke in favour of stoma closure. Intraoperatively the stoma was completely closed in 9 patients and in 3 patients a subtotal closure was observed. In all cases a re-ventriculostomy was performed bluntly with a Fogarty catheter in loco typico at the floor of the third ventricle. Of the 12 patients 6 had an excellent outcome postoperatively, one patient improved and one had a benefit from the re-ventriculostomy although he died of cardiac problems. In the remaining 4 patients the re-ventriculostomy was not successful and the patients needed a shunt operation. In conclusion, after initially successful endoscopic third ventriculostomy, re-ventriculostomy should be considered as a sufficient treatment option in case of suspected stoma dysfunction.

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D. Koch,M. D. 

Department of Neurosurgery · Johannes Gutenberg University

55131 Mainz

Germany ·

Phone: +49-6131-177331

Fax: +49-6131-177331

Email: koch@nc.klinik.uni-mainz.de