TITLE:
Endoscopic Third Ventriculostomy with or without Choroid Plexus Coagulation for Treatment of Hydrocephalus in Guinea: Analysis of 76 Cases in the Department of Neurosurgery of Kipe, Conakry
AUTHORS:
I. S. Souare, A. B. Bah, S. Diawara, I. Berete, I. J. S. Souare, D. T. Boubane, M. Cherif, A. M. Camara, L. K. Beavogui
KEYWORDS:
Hydrocephalus, Endoscopic Third Ventriculostomy, Choroid Plexus Coagulation, Low-Income Countries
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.11 No.4,
October
12,
2021
ABSTRACT: In low-income countries, endoscopic third ventriculostomy
(ETV) with or without choroid plexus coagulation (CPC) is an increasingly
accepted alternative to shunt therapy in adult and pediatric hydrocephalus. The
authors report the result of this treatment in Conakry in a mixed population of
adult and pediatric patients regardless of the etiology of the hydrocephalus. A
retrospective study was conducted on 76 patients undergoing 89 ETV from January
2013 to September 2020. The predominant group of patients was infants less than
one year with a mean age of 4.3 months and extremes of 1 - 8
months. The H/F sex ratio was 1.7/1. All patients presented acutely with signs
of high intracranial pressure. Post-infectious causes and malformations and
tumors were the main etiologies, respectively 21%, 47.3%, and 15.7%. The mean
duration of the endoscopic procedures was 49.93 ± 10.9
mm, associated with a choroid plexus coagulation in 42% of cases. The
complication rate in the first month was 22%, with CSF leak (5%) and death
(11%) accounting for the majority. At three months, the complications rates
were 45%, with 14.4% closed stroma, 6% epilepsy, and 24% mortality. The mean
follow-up was 28 months (range 2 - 53),
and the global success rate of 61%. Our study, with its limitations, shows that
ETV with CPC is a safe primary approach for the treatment of hydrocephalus in
low-income countries regardless of the etiology and the age of the patients.