Hydrocephalus

Endoscopic third ventriculostomy (ETV)

The endoscope is inserted through a small opening in the skull and opening of the third ventricle floor (membrane) is performed under endoscopic vision.
Surgery takes 20 minutes and can save insertion of ventriculo-peritoneal shunt in cases of obstructive hydrocephalus.

Endoscopic septum pellucidotomy

Opening of the septum between the two lateral ventricles in case of obstruction of one of Monro’s foramen (hole).

Endoscopic biopsy or removal of intraventricular tumors with hydrocephalus

Anatomy of the ventricles

There are four ventricles which contain the cerebro-spinal fluid (CSF).
Two are lateral, draining CSF to the third ventricle through the Monro foramen. From the third ventricle the CSF drains to the fourth ventricle through the Silvian aqueduct (conduit). From the fourth ventricle the CSF draines into the sub-arachnoid and cerebral convexity.

Pathology for hydrocephalus

Any obstruction in drainage or absorbtion of CSF can lead to enlarged ventricles (hydrocephalus). It can be caused by tumors like colloid cyst.

Symptoms

If hydrocephalus develops gradually, symptoms may be gradual with headaches, gait changes, urinary incontinence and dementia (Hakim triade).
In case of acute hydrocephalus symptoms will be more severe with severe headache, blurred vision and even sudden death.

Indications for surgery

A)   Obstructive hydrocephalus.
B)   Intraventricular tumor with obstructive hydrocephalus.

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Dr. Shlomo Davidovich heads the minimally invasive Department of Neuroendoscopy located at the renowned Rabin Medical Center in Israel, known for its world class medical treatment facilities.

* The information above is partial and for general knowledge. Professional literature is recommended for more complete information.