Treatment of post-thalamic hemorrhage hydrocephalus: Ventriculoperitoneal shunt or endoscopic third ventriculostomy?

Author:

Lu Wenchao1,Du Andong2,Zheng Xiaomin3

Affiliation:

1. Clinical Medicine School of Ningxia Medical University, Ningxia Hui Autonomous Region

2. People’s Hospital of Ningxia Hui Autonomous Region

3. People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Hui Autonomous Region

Abstract

Abstract Background This study aimed to compare the efficacy of ventriculoperitoneal shunt (VPS) and endoscopic third ventriculostomy (ETV) in the treatment of hydrocephalus after thalamic hemorrhage to provide reasonable surgical treatment. Methods The clinical data of 87 patients with hydrocephalus after TH whose external ventricular drainage(EVD) cannot be removed after hematoma absorption were retrospectively analyzed. The patients were divided into the VPS and ETV groups according to the different surgical methods. The operative time, length of hospital stay, complications, and reoperation rates of the two groups were compared. Results There was no statistically significant difference in intraoperative bleeding and length of hospital stay between the two groups, and all patients had the EVD tube successfully removed after surgery. There were 4 (9.5%) complications in the ETV group and 3 (6.7%) complications in the VPS group, with no significant differences in postoperative complications between the two groups.During the 1-year follow up,7 patients (16.7%) in the ETV group and 3 patients (6.7%) in the VPS group required reoperation. There was a significant difference in the reoperation rates between the two groups. In the subgroup analysis of TH with fourth ventricular hemorrhage, 6 patients (14.3%) required reoperation in the ETV group, and 1 patient (2.2%) required reoperation in the VPS group; the difference between the two groups was statistically significant. Conclusions ETV have good efficacy in treating hydrocephalus caused by TH and TH breaking into the lateral ventricle and the third ventricle. However, if hydrocephalus is caused by TH with the fourth ventricular hematoma, VPS is a better surgical method because the recurrence rate of hydrocephalus in ETV is higher than that in VPS. Therefore, the choice of surgical method should be based on the patient’s clinical manifestations and hematoma type.

Publisher

Research Square Platform LLC

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