{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T03:27:45Z","timestamp":1776482865360,"version":"3.51.2"},"reference-count":25,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2012,7]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Electrolyte and endocrinological complications of endoscopic third ventriculostomy (ETV) are infrequent but serious events, likely due to transient hypothalamic-pituitary dysfunction. While the incidence of diabetes insipidus is relatively well known, hyponatremia is not often reported. The authors report on a series of 5 patients with post-ETV hyponatremia.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The records of patients undergoing ETV between 2008 and 2010 were reviewed. All ETVs were performed with a rigid neuroendoscope via a frontal bur hole, standard third ventricle floor blunt perforation, Fogarty catheter dilation, and intermittent normal saline irrigation. Postoperative MR images were evaluated for endoscope tract injury as well as the trajectory from the bur hole center to the fenestration site.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Thirty-two patients (20 male and 12 female) underwent ETV. Their median age was 6 years (range 3 weeks\u201328 years). Hydrocephalus was most commonly due to nontumoral aqueductal stenosis (43%), nontectal tumor (25%), or tectal glioma (13%). Five patients (16%) had multicystic\/loculated hydrocephalus. Five patients (16%) developed hyponatremia between 1 and 8 days following ETV, including 2 patients with seizures (1 of whom was still hospitalized at the time of the seizure and 1 of whom was readmitted as a result of the seizure) and 3 patients who were readmitted because of decline in their condition following routine discharge. No hypothalamic injuries were noted on imaging. Univariate risk factors consisted of age of 2 years or less (p = 0.02), presence of cystic lesions (p = 0.02), and ETV trajectory angle 10\u00b0 or more from perpendicular (p = 0.001).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Endoscopic third ventriculostomy is a well-tolerated procedure but can result in serious complications. Hyponatremia is rare and may be more likely in younger patients or those with cystic loculations. Patients with altered craniometry may be at particular risk with a rigid endoscopic approach requiring greater manipulation of subforniceal or hypothalamic structures.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2012.4.peds1222","type":"journal-article","created":{"date-parts":[[2012,6,15]],"date-time":"2012-06-15T15:44:02Z","timestamp":1339775042000},"page":"39-43","source":"Crossref","is-referenced-by-count":9,"title":["Hyponatremia following endoscopic third ventriculostomy: a report of 5 cases and analysis of risk factors"],"prefix":"10.3171","volume":"10","author":[{"given":"Shih-Shan","family":"Lang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel A.","family":"Bauman","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael W.","family":"Aversano","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew R.","family":"Sanborn","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arastoo","family":"Vossough","sequence":"additional","affiliation":[{"name":"Department of Radiology, Children's Hospital of Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory G.","family":"Heuer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia; and"},{"name":"Division of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phillip B.","family":"Storm","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia; and"},{"name":"Division of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-peds1222","series-title":"J Neurosurg Anesthesiol","first-page":"33","article-title":"Ten years of experience with pediatric neuroendoscopic third ventriculostomy: features and perioperative complications of 210 cases","volume":"17","author":"Baykan","year":"2005"},{"key":"b2-peds1222","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1007\/s00381-002-0652-6","article-title":"Is the success rate of endoscopic third ventriculostomy age-dependent? An analysis of the results of endoscopic third ventriculostomy in young children","volume":"18","author":"Beems","year":"2002"},{"key":"b3-peds1222","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"486","DOI":"10.3171\/2010.8.PEDS10156","article-title":"Suprasellar arachnoid cyst resulting in the syndrome of inappropriate antidiuretic hormone secretion. Case report","volume":"6","author":"Beier","year":"2010"},{"key":"b4-peds1222","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1032","DOI":"10.3171\/jns.2003.98.5.1032","article-title":"Endoscopic third ventriculostomy for shunt dysfunction in occlusive hydrocephalus: long-term follow up and review","volume":"98","author":"Boschert","year":"2003"},{"key":"b5-peds1222","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"643","DOI":"10.3171\/2011.4.PEDS10503","article-title":"Complications of endoscopic third ventriculostomy. A review","volume":"7","author":"Bouras","year":"2011"},{"key":"b6-peds1222","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1159\/000028657","article-title":"Endoscopic third ventriculostomy: an outcome analysis","volume":"28","author":"Brockmeyer","year":"1998"},{"key":"b7-peds1222","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1016\/S0090-3019(01)00352-4","article-title":"Neuroendoscopic third ventriculostomy for hydrocephalus in adults: report of a single unit's experience with 63 cases","volume":"55","author":"Buxton","year":"2001"},{"key":"b8-peds1222","series-title":"Ann Fr Anesth Reanim","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1016\/S0750-7658(00)88456-7","article-title":"[Ventriculostomy of the third ventricle and diabetes insipidus.]","volume":"18","author":"Di Roio","year":"1999"},{"issue":"2 Suppl","key":"b9-peds1222","series-title":"J Neurosurg","first-page":"118","article-title":"Late rapid deterioration after endoscopic third ventriculostomy: additional cases and review of the literature","volume":"105","author":"Drake","year":"2006"},{"key":"b10-peds1222","series-title":"Minim Invasive Neurosurg","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1055\/s-2003-812436","article-title":"Blood biochemistry following endoscopic third ventriculostomy","volume":"47","author":"El-Dawlatly","year":"2004"},{"key":"b11-peds1222","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1007\/s00381-010-1254-3","article-title":"Endoscopic third ventriculostomy for hydrocephalus in children younger than 1 year of age","volume":"27","author":"Elgamal","year":"2011"},{"key":"b12-peds1222","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1007\/s00381-007-0326-5","article-title":"Endocrine evaluation after endoscopic third ventriculostomy (ETV) in children","volume":"23","author":"Fritsch","year":"2007"},{"key":"b13-peds1222","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"298","DOI":"10.3171\/PED.2008.2.11.298","article-title":"Intraoperative assessment of endoscopic third ventriculostomy success. Clinical article","volume":"2","author":"Greenfield","year":"2008"},{"key":"b14-peds1222","series-title":"Neurocrit Care","article-title":"Cerebral salt wasting syndrome in post-operative pediatric brain tumor patients","author":"Hardesty","year":"2011"},{"key":"b15-peds1222","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"609","DOI":"10.3171\/2011.3.PEDS1120","article-title":"Perioperative seizure incidence and risk factors in 223 pediatric brain tumor patients without prior seizures. Clinical article","volume":"7","author":"Hardesty","year":"2011"},{"key":"b16-peds1222","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"325","DOI":"10.3171\/2011.6.PEDS1137","article-title":"Amenorrhea complicating endoscopic third ventriculostomy in the pediatric age group. Report of 2 cases","volume":"8","author":"Hwang","year":"2011"},{"key":"b17-peds1222","series-title":"Minim Invasive Neurosurg","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1055\/s-2007-985844","article-title":"Endoscopic treatment of in utero diagnosed suprasellar arachnoid cyst and development of salt wasting","volume":"50","author":"I\u015fik","year":"2007"},{"key":"b18-peds1222","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1159\/000050406","article-title":"The impact of endoscopic third ventriculostomy on the management of newly diagnosed hydrocephalus in infants","volume":"35","author":"Javadpour","year":"2001"},{"key":"b19-peds1222","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1007\/s003810050485","article-title":"Surgical outcome of pediatric hydrocephalus treated by endoscopic III ventriculostomy: prognostic factors and interpretation of postoperative neuroimaging","volume":"16","author":"Kim","year":"2000"},{"key":"b20-peds1222","series-title":"Minim Invasive Neurosurg","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1055\/s-2008-1053447","article-title":"Endoscopic fenestration of the 3rd ventricular floor in aqueductal stenosis","volume":"37","author":"Kunz","year":"1994"},{"key":"b21-peds1222","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1007\/s00381-005-0031-1","article-title":"Endoscopic third ventriculostomy in children: early and late complications and their avoidance","volume":"22","author":"Navarro","year":"2006"},{"key":"b22-peds1222","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1032","DOI":"10.3171\/jns.2002.96.6.1032","article-title":"Complications of endoscopic third ventriculostomy","volume":"96","author":"Schroeder","year":"2002"},{"key":"b23-peds1222","series-title":"Childs Nerv Syst","first-page":"248","article-title":"Complications of endoscopic neurosurgery","volume":"12","author":"Teo","year":"1996"},{"key":"b24-peds1222","series-title":"Minim Invasive Neurosurg","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1055\/s-2000-11371","article-title":"Transient hyponatriemia complicated by seizures after endoscopic third ventriculostomy","volume":"43","author":"Vaicys","year":"2000"},{"key":"b25-peds1222","series-title":"Neurol India","first-page":"161","article-title":"Endoscopic third ventriculostomy in infants","volume":"54","author":"Yadav","year":"2006"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/10\/1\/article-p39.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/10\/1\/article-p39.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/10\/1\/article-p39.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T14:36:31Z","timestamp":1681569391000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/10\/1\/article-p39.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2012,7]]},"references-count":25,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2012.4.peds1222","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,7]]}}}