Endoscopic Third Ventriculostomy in the Treatment of Late-Onset Idiopathic Aqueductal Stenosis: Outcome Evaluation.

BACKGROUND: Endoscopic third ventriculostomy is the shunt-independent surgical treatment for hydrocephalus caused by late-onset idiopathic aqueductal stenosis. OBJECTIVE: This study aims to evaluate the success rate and the clinical and radiological outcomes of endoscopic third ventriculostomy in late-onset idiopathic aqueductal stenosis. PATIENTS AND METHODS: A retrospective analysis was conducted on 15 patients (9 males and 6 females) with hydrocephalus due to late-onset idiopathic aqueductal stenosis in whom endoscopic third ventriculostomy was performed. Different clinical, radiological and operative factors affecting the outcome were analyzed. RESULTS: Twelve patients in our study had a chronic clinical history (class III), and 3 cases had subacute symptoms (class II). Success was obtained in 14 patients (93.3%) while failure was reported in one patient only (6.7%). Headache and gait disturbance improved in all patients, while 5 of the 8 patients with cognitive impairment and 4 of the 6 patients with urinary incontinence showed improvement. The postoperative images showed radiological improvement in 14 patients, with evident reduction in ventricular size in only 3 patients (20%). CONCLUSION: Endoscopic third ventriculostomy is a safe, effective, and highly successful procedure in the treatment of hydrocephalus due to idiopathic aqueductal stenosis, with more than 93.3% success rate. To enhance our findings, further carefully planned, prospective, multicentric studies on bigger samples should be performed. [ABSTRACT FROM AUTHOR]