Endoscopic Third Ventriculostomy
https://www.neuroendo.net/wp-content/uploads/2017/10/Endoscopic-Third-Ventriculostomy-adult-feature.jpg 560 560 Henry Schroeder Henry Schroeder http://www.neuroendo.net/wp-content/uploads/2017/10/SchroederH-96x96.jpgEndoscopic Third Ventriculostomy
Diagnosis: Normal Pressure Hydrocephalus
- 75-year-old man
- Dizziness, gait disorder, intermittent headaches, progressive symptoms over one year
- MR scan at presentation: large ventricles, periventricular lucency, high flow signal at the aqueduct
- ETV is not our preferred treatment for NPH, but the patient was participating in a randomized study ETV vs shunt
- ETV was performed
Equipment Used
- Storz Lotta Endoscope
- 0o and 30o lenses
- Decq forceps
- 2F Fogarty balloon
Surgical Tips
- On insertion in to the lateral ventricle, the optical lens can be kept slightly retracted, to allow the use of the external endoscope sheath to be used as a probe
- Blunt perforation of the floor of the 3rd ventricle with the Decq forceps
- Inspection of the prepontine cistern and the ventricular walls with the 30o optical lens