Endoscopic third ventriculostomy in mechanically malfunctioning shunts in non-communicating hydrocephalic cases shunted below one year of age / Ahmed Mohamed Ahmed Alselisly ; Supervised Omar Osman Sorour , Hassan Ismail Elshafei , Ahmed Elsaid Ahmed

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Neurosurgery

Background: Endoscopic third ventriculostomy is a widely accepted treatment for non-communicating hydrocephalus.1 However, in patients less than one year of age, ETV has low success rates.2,3 So using CSF shunts proved to be more effective method for treatment in this age group.2,3 However, when these cases presented with mechanical shunt malfunction, when they are older than one year, they can get benefit of the advantage of endoscopic third ventriculostomy.4,5. Objectives: To determine the success rate of ETV done in this group of patients, and evaluate different factors which determine the success rate. Patients and methods: Thirty patients, older than one year, presented with manifestations of mechanical shunt malfunction, which was implanted in them below one year of age due to non-communicating hydrocephalus, underwent ETV. Clinical and radiological assessment of the patients were performed immediate after surgery, one month, two months and four months after surgery for assessment of hydrocephalus and patency of the ventriculostomy. Results: Out of the 30 patients presented to Cairo University hospitals with mechanical shunt malfunction from the period from July 2015 to October 2016, ETV was successful to control the hydrocephalus in twenty one patients (70%). The mean age of patients with successful ETV was 11 years. The mean age of patients with failed ETV was 4.7 years. The mean follow up period for patients with successful ETV was 10.5 months

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