Introduction: The endoscopic third ventriculostomy (ETV) has been used as the first line of treatment for obstructive hydrocephalus. There is still controversy regarding its indications and long-term results. New studies with long-term follow-up are necessary to properly establish the real benefits of this treatment.

Methods: Retrospective study of 100 hydrocephalic patients submitted to endoscopic third-ventriculostomy between May 2004 and July 2011.

Results: There were 52 male e 48 female patients with age ranging from 1 month to 83 years of life (average 24 years and 6 months). The patients were followed for at least 41 months. More than 50% of the patients had an obstruction of the liquor's flow at the level of aqueduct (aqueduct stenosis, brainstem tumors). The procedure was considered successful when the patients were symptoms free and were not submitted to a shunt in 88,3% of the cases. All of these patients had a MRI with flow study showing patency of the ventriculostomy. There were 15 complications (meningitis and/or CSF leak) and 4% of mortality (2 patients had meningitis before the ETV).

Conclusions: ETV is an effective procedure to treat obstructive hydrocephalus with successful long-term results. Meningitis can be a serious complication but probably less frequent in ETV than in shunts.

Patient Care: This research presents log term results that prove the effectiveness of ETV in the treatment of obstructive hydrocephalus

Learning Objectives: By the conclusion of this session participants should be able to identify ETV as a reliable option to treat obstructive hydrocephalus.

References: Hellwig, D.; Grotenhuis, J.A.; Tirakotai, W.; Riegel, T.; Schulte, D.M.; Bauer , B.L.; Bertalanffy, H. : Endoscopic third ventriculostomy for obstructive hydrocephalus. Neurosurg Rev (2005) 28: 1–34. Zymberg ST, Marinello JLP, Filho FAVG, Cavalheiro S. Endoscopic Third Ventriculostomy. J Bras Neurocirurg 19 (2): 42-47, 2008.