Endoscopic Third Ventriculostomy

560 560 Spyros Sgouros

Endoscopic Third Ventriculostomy

Diagnosis: aqueduct stenosis due to quadrigeminal plate lesion
  •  11-year-old boy
  •  Headaches for several months
  •  MR scan at presentation: large ventricles, periventricular lucency, hamartomatous lesion in the quadrigeminal plate region causing aqueduct stenosis
  • ETV was performed
  • Postoperative MR scan shows decrease of the ventricular size, disappearance of the periventricular lucency and good CSF flow signal at the region of the stoma at the floor of the 3rd ventricle
  • Symptoms settled. He remains well for 2 1/2 years
EQUIPMENT USED
  • Storz Oi HandyPro Endoscope
  • Integra neuro balloon (hourglass shaped balloon)
SURGICAL TIPS
  • Blunt perforation of the floor of the 3rd ventricle. The blunt monopolar lead was used as a probe (disconnected from power)
  • After formation of the stoma, the floor of the 3rd ventricle begins to flap, making cannulation of the stoma with the balloon difficult
  • Inspection of prepontine cistern, no well formed Lilliquist membrane was seen, arachnoid adhesions were dissected with balloon
Pre op
Post op
CONTRIBUTOR

Spyros Sgouros

• Head of the Department of Pediatric Neurosurgery, “Mitera” Childrens Hospital, Athens, Greece • Professor of Neurosurgery at National and “Kapodistrian” University of Athens, Greece

All cases by: Spyros Sgouros