Analysis of Cerebrospinal Fluid Flowmetry in Evaluating the Efficiency of Endoscopic Third Ventriculostomy in Aqueductal Stenosis

Background: Endoscopic third ventriculostomy (ETV) approach was gaining popularity over shunt placement in obstructive hydrocephalus. Postoperative ETV assessment and patients follow up remains a matter of controversy and challenge to ensure efficiency and patency of ventriculostomy. Aim of the work...

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Autores principales:	Mohammed Abo Shahba, Mohammed Alhady, Hatem El Samouly, Islam Elshwihi
Formato:	article
Lenguaje:	EN
Publicado:	Al-Azhar University, Faculty of Medicine (Damietta) 2020
Materias:	endoscopic ventriculostomy aqueductal stenosis cerebrospinal flowmetry Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/8272ab535049407fa019a681c6a5b25e
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spelling	oai:doaj.org-article:8272ab535049407fa019a681c6a5b25e2021-12-02T10:38:27ZAnalysis of Cerebrospinal Fluid Flowmetry in Evaluating the Efficiency of Endoscopic Third Ventriculostomy in Aqueductal Stenosis2636-41742682-378010.21608/ijma.2019.18702.1041https://doaj.org/article/8272ab535049407fa019a681c6a5b25e2020-01-01T00:00:00Zhttps://ijma.journals.ekb.eg/article_61203_efcf76c01c920d715abd32b8828b14fa.pdfhttps://doaj.org/toc/2636-4174https://doaj.org/toc/2682-3780Background: Endoscopic third ventriculostomy (ETV) approach was gaining popularity over shunt placement in obstructive hydrocephalus. Postoperative ETV assessment and patients follow up remains a matter of controversy and challenge to ensure efficiency and patency of ventriculostomy. Aim of the work: To assess whether cerebrospinal fluid (CSF) flow is restored after ETV and similarity to flow in normal aqueduct with patients clinical and ventricular size changes assessment. Patients and Methods: From April 2016 to April 2019, 30 patients with hydrocephalus due to aqueductal stenosis (AS) were treated with ETV. They were followed up for ventriculostomy patency within the 1st, 6th and 9th month after surgery and compared to 22 persons as a control group of normal aqueductal flow with phase contrast magnetic resonance imaging (PC MRI). Results: Twenty-three (23) patients restored pulsatile bidirectional pattern of CSF flow across the ventriculostomy similar to that of aqueductal flow. While one patient had no flow during the 1st follow up and 6 patients showed initial pulsatile flow then developed flow disturbance during the 2nd follow up period. Absolute stroke volume values showed significant statistical difference between ETV and control groups (p value < 0.001). The value of 85 μl showed sensitivity and specificity of 84.3% and 81.7%, respectively as a cutoff value of ETV efficiency. Conclusion: ETV is an efficient technique to restores the physiological pulsatile Cerebrospinal fluid flow. Absolute stroke volume was a good predictor of ETV efficiency.Mohammed Abo ShahbaMohammed AlhadyHatem El SamoulyIslam ElshwihiAl-Azhar University, Faculty of Medicine (Damietta)articleendoscopicventriculostomyaqueductal stenosiscerebrospinalflowmetryMedicine (General)R5-920ENInternational Journal of Medical Arts, Vol 2, Iss 1, Pp 191-198 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	endoscopic ventriculostomy aqueductal stenosis cerebrospinal flowmetry Medicine (General) R5-920
spellingShingle	endoscopic ventriculostomy aqueductal stenosis cerebrospinal flowmetry Medicine (General) R5-920 Mohammed Abo Shahba Mohammed Alhady Hatem El Samouly Islam Elshwihi Analysis of Cerebrospinal Fluid Flowmetry in Evaluating the Efficiency of Endoscopic Third Ventriculostomy in Aqueductal Stenosis
description	Background: Endoscopic third ventriculostomy (ETV) approach was gaining popularity over shunt placement in obstructive hydrocephalus. Postoperative ETV assessment and patients follow up remains a matter of controversy and challenge to ensure efficiency and patency of ventriculostomy. Aim of the work: To assess whether cerebrospinal fluid (CSF) flow is restored after ETV and similarity to flow in normal aqueduct with patients clinical and ventricular size changes assessment. Patients and Methods: From April 2016 to April 2019, 30 patients with hydrocephalus due to aqueductal stenosis (AS) were treated with ETV. They were followed up for ventriculostomy patency within the 1st, 6th and 9th month after surgery and compared to 22 persons as a control group of normal aqueductal flow with phase contrast magnetic resonance imaging (PC MRI). Results: Twenty-three (23) patients restored pulsatile bidirectional pattern of CSF flow across the ventriculostomy similar to that of aqueductal flow. While one patient had no flow during the 1st follow up and 6 patients showed initial pulsatile flow then developed flow disturbance during the 2nd follow up period. Absolute stroke volume values showed significant statistical difference between ETV and control groups (p value < 0.001). The value of 85 μl showed sensitivity and specificity of 84.3% and 81.7%, respectively as a cutoff value of ETV efficiency. Conclusion: ETV is an efficient technique to restores the physiological pulsatile Cerebrospinal fluid flow. Absolute stroke volume was a good predictor of ETV efficiency.
format	article
author	Mohammed Abo Shahba Mohammed Alhady Hatem El Samouly Islam Elshwihi
author_facet	Mohammed Abo Shahba Mohammed Alhady Hatem El Samouly Islam Elshwihi
author_sort	Mohammed Abo Shahba
title	Analysis of Cerebrospinal Fluid Flowmetry in Evaluating the Efficiency of Endoscopic Third Ventriculostomy in Aqueductal Stenosis
title_short	Analysis of Cerebrospinal Fluid Flowmetry in Evaluating the Efficiency of Endoscopic Third Ventriculostomy in Aqueductal Stenosis
title_full	Analysis of Cerebrospinal Fluid Flowmetry in Evaluating the Efficiency of Endoscopic Third Ventriculostomy in Aqueductal Stenosis
title_fullStr	Analysis of Cerebrospinal Fluid Flowmetry in Evaluating the Efficiency of Endoscopic Third Ventriculostomy in Aqueductal Stenosis
title_full_unstemmed	Analysis of Cerebrospinal Fluid Flowmetry in Evaluating the Efficiency of Endoscopic Third Ventriculostomy in Aqueductal Stenosis
title_sort	analysis of cerebrospinal fluid flowmetry in evaluating the efficiency of endoscopic third ventriculostomy in aqueductal stenosis
publisher	Al-Azhar University, Faculty of Medicine (Damietta)
publishDate	2020
url	https://doaj.org/article/8272ab535049407fa019a681c6a5b25e
work_keys_str_mv	AT mohammedaboshahba analysisofcerebrospinalfluidflowmetryinevaluatingtheefficiencyofendoscopicthirdventriculostomyinaqueductalstenosis AT mohammedalhady analysisofcerebrospinalfluidflowmetryinevaluatingtheefficiencyofendoscopicthirdventriculostomyinaqueductalstenosis AT hatemelsamouly analysisofcerebrospinalfluidflowmetryinevaluatingtheefficiencyofendoscopicthirdventriculostomyinaqueductalstenosis AT islamelshwihi analysisofcerebrospinalfluidflowmetryinevaluatingtheefficiencyofendoscopicthirdventriculostomyinaqueductalstenosis
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Analysis of Cerebrospinal Fluid Flowmetry in Evaluating the Efficiency of Endoscopic Third Ventriculostomy in Aqueductal Stenosis

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