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J Neurol Surg A Cent Eur Neurosurg 2017; 78(02): 132-136
DOI: 10.1055/s-0035-1564050
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Experience with Lumbar Puncture Following Endoscopic Third Ventriculostomy for Obstructive Hydrocephalus

Zhiqiang Hu
1   Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
,
Zhuang Kang
1   Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
,
Guangtong Zhu
1   Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
,
Jian Tu
2   Department of Neuroscience, The Prince of Wales Hospital, University of New South Wales, Sydney, Australia
,
Hui Huang
1   Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
,
Feng Guan
1   Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
,
Bin Dai
1   Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
,
Beibei Mao
1   Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
› Author Affiliations
Further Information

Publication History

19 January 2015

03 July 2015

Publication Date:
04 August 2016 (online)

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Abstract

Background and Objective The increase in intracranial pressure (ICP) in some patients in the immediate postoperative period following endoscopic third ventriculostomy (ETV) is not well understood. This study explored the effect of lumbar puncture following ETV for obstructive hydrocephalus on outcome.

Materials and Methods A total of 145 patients with obstructive hydrocephalus underwent ETV between 2009 and 2014. Following ETV, all patients underwent lumbar puncture on postoperative days 1 and 3.

Results In 106 patients, ICP returned to normal levels accompanied by symptom relief. In 39 patients, ICP remained high on postoperative days 3, and lumbar puncture was continued every alternate postoperative day for 11 days. ICP always returned to normal. These 39 patients were divided into two groups for analysis: group A (age < 18 years) and group B (age ≥ 18 years). Peak values of ICP for groups A and B were recorded on days 3 and 5, respectively.

Conclusions Our study suggests an important role for postoperative lumbar puncture in ensuring successful treatment results after ETV. In most of the symptomatic patients with obstructive hydrocephalus, lumbar puncture appears to contribute to rapid ICP normalization, to alleviation of symptoms, and prevention of complications.

Keywords

endoscopic third ventriculostomy - cerebrospinal fluid circulation - lumbar puncture - intracranial pressure - subarachnoid space
 

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