Endoscopic third ventriculostomy
Endoscopic third ventriculostomy (ETV) is a surgical procedure in which an opening is created in the floor of the third ventricle using an endoscope placed within the ventricular system through a burr hole. This allows the cerebrospinal fluid to flow directly to the basal cisterns, thereby shortcutting any obstruction. It is used as an alternative to a cerebral shunt to treat certain forms of obstructive hydrocephalus, such as aqueductal stenosis. Complications include subarachnoid hemorrhage, basilar artery injury and hypothalamic or pituitary injury.
When it is not possible to perform an ETV for different reasons, an alternative treatment is opening the lamina terminalis anterior to the third ventricle. The effectiveness of this approach is not certain.
- Hydrocephalus and Treatment: Shunts and Endoscopic Third Ventriculostomy, AboutKidsHealth.ca
- Oertel, Joachim M. K.; Vulcu, Sonja; Schroeder, Henry W. S.; Konerding, Moritz A.; Wagner, Wolfgang; Gaab, Michael R. (2010). "Endoscopic transventricular third ventriculostomy through the lamina terminalis". Journal of Neurosurgery 113 (6): 1261–9. doi:10.3171/2010.6.JNS09491. PMID 20707616.
- Komotar, Ricardo J.; Hahn, David K.; Kim, Grace H.; Starke, Robert M.; Garrett, Matthew C.; Merkow, Maxwell B.; Otten, Marc L.; Sciacca, Robert R.; Connolly, E. Sander (2009). "Efficacy of lamina terminalis fenestration in reducing shunt-dependent hydrocephalus following aneurysmal subarachnoid hemorrhage: A systematic review". Journal of Neurosurgery 111 (1): 147–54. doi:10.3171/2009.1.JNS0821. PMID 19284236.
- More about the ETV procedure from an article on the website of the Association for Spina Bifida and Hydrocephalus
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