Endoscopic Third Ventriculostomy

560 560 Henry Schroeder

Endoscopic 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
Pre op
Post op
CONTRIBUTOR

Henry Schroeder

Chairman, Department of Neurosurgery, Ernst-Moritz-Arndt University, Greifswald, Germany

All cases by: Henry Schroeder