Article
Hygromas after endoscopic third ventriculostomy in infants younger than one year
Hygrome nach endoskopischer Ventrikulozisternostomie im Säuglingsalter
Search Medline for
Authors
Published: | April 11, 2007 |
---|
Outline
Text
Objective: Hygromas are a well known complication after surgery for hydrocephalus. Whereas overdrainange in shunted patients is a known predisposing factor for the formation of hygromas, little is known about risk factors in endoscopic third ventriculostomy (ETV).
Methods: Between October 1994 and November 2006, we performed ETV in 33 patients <1 y old that were analyzed with respect to incidence, management, outcome and possible risk factors for the formation of hygromas after ETV.
Results: Hygromas over the hemispheric convexities (more than 10 mm in diameter) were diagnosed by ultrasound or MRI. They occured in 9/33 (27%) of the patients 3-28 days after ETV, and were unilateral (ipsilateral) in 4 and bilateral in 5 cases. There was no age difference between patients with hygromas (mean 136, median 127, range 24-248 days) and those without hygromas (mean 146, median 166, range 2-311 days). Etiology of obstructive hydrocephalus (idiopathic aqueductal stenosis vs. other pathologies) had no impact on the incidence of hygromas. Hygromas were asymptomatic in 5 cases (spontaneous resolution or decrease over weeks). In 4 cases, they required surgery because of clinical symptoms (external drainage for a few days in 2 patients, subduro-peritoneal shunt in 2 patients, performed 8-35 days after ETV).
Conclusions: Hygromas after ETV may occur more often than generally reported, when systematic ultrasound scans are performed after surgery. However, they required surgery in only a part of our patients and neurological long-term sequelae were not seen. Predisposing factors for the formation of hygromas could not be identified.