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Endoscopic Third Ventriculostomy for Hydrocephalus Due to Tectal Glioma

Published online by Cambridge University Press:  20 October 2014

Roberto Jose Diaz ,
Fady M. Girgis  and
Mark G. Hamiltonn
Roberto Jose Diaz
Affiliation:
Division of Neurosurgery, Department of Clinical Neurosciences, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada
Fady M. Girgis
Affiliation:
Division of Neurosurgery, Department of Clinical Neurosciences, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada
Mark G. Hamiltonn*
Affiliation:
Division of Neurosurgery, Department of Clinical Neurosciences, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada
*
Division of Neurosurgery, Department of Clinical Neurosciences, 12th Floor, Foothills Medical Centre, 1403-29th St. NW, Calgary, Alberta, T2N 2T9, Canada. Email: mghamilton.hydro@gmail.com.
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Abstract

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Background:

Tectal gliomas commonly present with hydrocephalus from obstruction of the aqueduct of Sylvius. The creation of a ventriculostomy in the floor of the third ventricle (ETV) has been previously reported to by-pass aqueduct obstruction. The goal of this study was to determine the safety and efficacy of ETV in the presence of an obstructing tectal glioma.

Methods:

We retrospectively reviewed the clinical presentation, management, and clinical outcome after ETV in patients diagnosed with tectal glioma and obstructive hydrocephalus in our institution over a period of 15 years. Shunt freedom at follow-up was the main outcome variable. Long-term clinical outcome was assessed at the most recent clinic visit. Clinical outcome was ranked as excellent, good, or poor according to resolution of symptoms and patient functional status.

Results:

The median age at presentation was 16.5 years (range: 6.4 to 59 years) and the most common presenting symptom was headache. Eleven patients had ETV as a primary procedure and three patients underwent ETV as a substitute for shunt revision at the time of shunt failure. At follow-up (median 3.9 years, range: 2.2 to 7 years) 13 of 14 patients remain shunt independent with excellent (n=9) or good outcomes (n=5).

Conclusions:

In patients with tectal glioma causing obstructive hydrocephalus, ETV can be performed safely in the primary setting or as a substitute for shunt revision. A high rate of shunt freedom (78%-100%) at prolonged follow-up can be expected in this patient population.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 41 , Issue 4 , July 2014 , pp. 476 - 481
Copyright
Copyright © The Canadian Journal of Neurological 2014

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