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Some patients with hydrocephalus can be treated with an alternative procedure called an Endoscopic Third Ventriculostomy (often referred to as an ETV, or Third Vent). For this operation, a tiny burr hole is made in the skull and a neuroendoscope (a small camera which is attached to a medical instrument) is utilized to enter the brain. The physician will then make a small hole (several millimeters) in the floor of the third ventricle. This allows the CSF to flow from the blocked ventricles into the open spaces surrounding the brain, and then into the veins around the brain where the fluid is absorbed.

third ventriculostomyIf the operation is successful, it will eliminate the need for a shunt. However, not everyone with hydrocephalus has the anatomy that makes them a candidate for this type of operation. Many physicians prefer that the patient is older than 2 years of age, as the success rate is lower in infants.

Although a Third Ventriculostomy eliminates the need for a shunt, it must not be thought of as a fail-proof cure for hydrocephalus. The opening in the third ventricle can close, causing symptoms similar to those present during shunt failure.

Are there complications?

In both the shunt implantation and third Ventriculostomy, there is a very small chance of complications occurring. As stated previously, hydrocephalus (and in most cases, shunts) are life-long conditions. There will be revisions from time-to-time. The average shunt is revised about 10 times during a life-time.

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