Endoscopic Third Ventriculostomy: Symptoms, Classification, Diagnosis & Recovery

Endoscopic third ventriculostomy (ETV) is a surgical procedure used to treat obstructive hydrocephalus, a condition characterized by the accumulation of cerebrospinal fluid (CSF) in the brain. CSF is produced in the ventricular system of the brain, which consists of four cavities - two lateral ventricles, the third ventricle, and the fourth ventricle - interconnected by channels.

The third ventricle, situated centrally above the base of the skull, plays a crucial role in CSF circulation. In cases of obstructive hydrocephalus, CSF flow is impeded due to blockage, often occurring at the passage between the third and fourth ventricles, known as the cerebral aqueduct.

ETV involves creating a new pathway for CSF to bypass the blockage by making a small hole in the floor of the third ventricle using an endoscope. This allows CSF to flow directly into the subarachnoid space surrounding the brain, relieving pressure and reducing ventricle enlargement.

Classification:

Based on the Underlying Cause of Hydrocephalus

• Congenital Obstructive Hydrocephalus
• Acquired Obstructive Hydrocephalus

Based on Patient Demographics

• Pediatric ETV
• Adult ETV
• Standard ETV

Based on the Surgical Approach

• Flexible Endoscope ETV
• Rigid Endoscope ETV

Following are the signs and symptoms before undergoing endoscopic third ventriculostomy

• Headaches
• Nausea and Vomiting
• Visual Disturbances
• Blurred or double vision,
• Balance and Coordination Problems
• Cognitive and Memory Issues
• Irritability and Behavioral Changes
• Lethargy and Sleepiness