{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T11:04:43Z","timestamp":1772795083381,"version":"3.50.1"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2009,12]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Endoscopic third ventriculostomy (ETV) is well accepted for obstructive hydrocephalus of various etiologies. Nevertheless, it is seldom considered in intracranial hemorrhage even in cases involving obstruction of the CSF circulation.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Between May 1993 and April 2008, 34 endoscopic procedures were performed for hemorrhage-related obstructive hydrocephalus with an intraventricular component. All patients were prospectively followed up. Special attention was paid to presurgical clinical status, type of hemorrhage, type of surgery, postsurgical clinical status, postsurgical ventricular size, and necessity of ventriculoperitoneal shunt implantation.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>An ETV was performed for treatment of obstructive hydrocephalus due to intracranial hemorrhage in 34 patients (15 male, 19 female; mean age 60.8 years [range 3 months\u201383 years]). Hydrocephalus was caused by 17 cerebellar, 6 thalamic, 5 intraventricular, 3 basal ganglia, 2 subarachnoid, and 1 pontine hemorrhage. Thirty-three patients (97.1%) presented with impaired consciousness. Intraventricular blood was present in all cases. In 16 cases (47.1%), blood clots had to be evacuated to achieve access to the third ventricle floor. The mean operation time was 58.2 minutes (range 25\u2013120 minutes). Three complications occurred (rate of 8.8%) with 2 being asymptomatic (5.9%) and 1 being transient (2.9%). There was no procedure-related permanent morbidity, and no procedure-related mortality. After surgery, there was clinical improvement in 17 cases (50.0%) and radiological evidence of improvement in 22 cases (64.7%). Two patients required postoperative ventriculoperitoneal shunting (5.9%). Seven patients died of hemorrhage while in the hospital (20.6%), and another 4 died during follow-up (11.8%). Fifteen patients (44.1%) showed a persistent clinical improvement at the final follow-up (mean 12.2 months after surgery).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Endoscopic third ventriculostomy represents a safe treatment option in intraventricular hemorrhage\u2013related obstructive hydrocephalus yielding similar results as an external drainage but with less risk of infection and a very low subsequent shunt placement rate. In cases with a predominant obstructive component, ETV should be considered in hydrocephalus due to intracerebral hemorrhage. However, performing an ETV with a blurred field of vision and distorted ventricular anatomy is a challenge for any endoscopic neurosurgeon and should be reserved for experienced neuroendoscopists.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2009.4.jns081149","type":"journal-article","created":{"date-parts":[[2009,5,8]],"date-time":"2009-05-08T16:13:15Z","timestamp":1241799195000},"page":"1119-1126","source":"Crossref","is-referenced-by-count":47,"title":["Endoscopic third ventriculostomy for obstructive hydrocephalus due to intracranial hemorrhage with intraventricular extension"],"prefix":"10.3171","volume":"111","author":[{"given":"Joachim M. K.","family":"Oertel","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Hannover Nordstadt Hospital, Hannover; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yvonne","family":"Mondorf","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hannover Nordstadt Hospital, Hannover; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joerg","family":"Baldauf","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ernst Moritz Arndt University, Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry W. S.","family":"Schroeder","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ernst Moritz Arndt University, Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael R.","family":"Gaab","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hannover Nordstadt Hospital, Hannover; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"1 Suppl","key":"b1-1111119","series-title":"J Neurosurg","first-page":"53","article-title":"Complications of intracranial pressure monitoring in children with head trauma","volume":"101","author":"Anderson","year":"2004"},{"key":"b2-1111119","series-title":"Neurosurgery","first-page":"539","article-title":"Endoscopic third ventriculostomy for occlusive hydrocephalus due to cerebellar infarction","volume":"59","author":"Baldauf","year":"2006"},{"key":"b3-1111119","series-title":"Childs Nerv Syst","first-page":"868","article-title":"Long-term complications and definition of failure of neuroendoscopic procedures","volume":"20","author":"Beems","year":"2004"},{"key":"b4-1111119","series-title":"Surg Neurol","first-page":"438","article-title":"Endoscopic surgery for thalamic hemorrhage: a technical note","volume":"68","author":"Chen","year":"2007"},{"key":"b5-1111119","series-title":"Yonsei Med J","first-page":"600","article-title":"Endoscopic surgery for obstructive hydrocephalus","volume":"40","author":"Choi","year":"1999"},{"key":"b6-1111119","series-title":"Pediatr Neurosurg","first-page":"127","article-title":"Endoscopic ventricular surgery","volume":"19","author":"Cohen","year":"1993"},{"key":"b7-1111119","series-title":"JAMA","first-page":"2216","article-title":"An experimental and clinical study on internal hydrocephalus","volume":"61","author":"Dandy","year":"1913"},{"key":"b8-1111119","series-title":"Neurochirurgie","first-page":"510","article-title":"[Endoscopic third ventriculostomy for management of obstructive hydrocephalus secondary to supratentorial intraventricular hematoma. 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