Failure of open third ventriculostomy for shunt infections in infants

• Published in: Pediatric neurosurgery Vol. 30; no. 6; p. 305
• Main Authors: Akdemir, H, Kurtsoy, A, Oktem, I S, Menkü, A, Koç, R K, Tucer, B
• Format: Journal Article
• Language: English
• Published: Switzerland 01-06-1999
• Subjects: Brain - diagnostic imaging; Cerebral Ventricles - microbiology; Cerebral Ventricles - surgery; Cerebrospinal Fluid Shunts - instrumentation; Equipment Failure; Female; Follow-Up Studies; Humans; Hydrocephalus - surgery; Infant; Male; Retrospective Studies; Staphylococcal Infections - microbiology; Tomography, X-Ray Computed
• ISSN: 1016-2291
• DOI: 10.1159/000028815

Open third ventriculostomy (OTV) was performed on 4 infants with noncommunicating hydrocephalus and intractable shunt infections. All patients were resistant or relapsed after treatment with intravenous and intraventricular antibiotics along with change of the shunt apparatus. We performed phase-contrast cine magnetic resonance imaging (MRI) for preoperative and postoperative evaluation of cerebrospinal fluid (CSF) flow at the aqueduct of Sylvius. All patients required a second OTV approximately 3 weeks after the first OTV due to closure of the patency. Our experience led us to view OTV as an unsuccessful procedure in infantile noncommunicating hydrocephalus due to an insufficiently developed subarachnoid space. The patients' data, operative findings and probable causes of failure are presented here.