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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La ventriculostomia endosc&#243;pica es en nuestro centro el tratamiento de primera elecci&#243;n para la hidrocefalia no comunicante&#46; Hay una serie de factores favorecedores de un fracaso de la intervenci&#243;n&#46; El objetivo de este trabajo ha sido analizar su influencia en nuestra serie&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Cincuenta y seis pacientes &#40;edad media 48&#46;5 a&#241;os&#41; han sido tratados mediante ventriculostomia endosc&#243;pica durante el periodo 1997&#8211;2002&#46; Se han diferenciado formas agudas &#40;68&#37;&#41; y formas cr&#243;nicas de hidrocefalia&#46; La etiolog&#237;a se clasific&#243; en lesiones ocupantes de espacio &#40;59&#37;&#41;&#44; estenosis primaria del acueducto &#40;34&#37;&#41; y malformaci&#243;n de Chiari &#40;7&#37;&#41;&#46; Consideramos los siguientes factores predisponentes al fracaso&#58; edad inferior a 12 meses&#44; antecedentes de mielomeningocele&#44; radioterapia&#44; craneotom&#237;a&#44; infecci&#243;n de l&#237;quido cefalorraqu&#237;deo &#40;LCR&#41;&#44; hemorragia intracraneal y tratamiento previo de la hidrocefalia con un shunt&#46; Se analiz&#243; la evoluci&#243;n de cuatro &#237;ndices de tama&#241;o ventricular comparando la &#250;ltima imagen postoperatoria con la preoperatoria&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Despu&#233;s de un periodo de seguimiento medio de 26 meses&#44; la intervenci&#243;n ha sido efectiva en el 71&#46;4&#37; de los pacientes&#46; La hidrocefalia secundaria a met&#225;stasis localizadas en &#225;reas que dificultan la circulaci&#243;n de LCR se asocia con fracaso de la ventriculostomia &#40;p&#61;0&#46;006&#41;&#46; Ninguno de los factores predisponentes al fallo ha mostrado relaci&#243;n con el resultado de la intervenci&#243;n&#46; La evoluci&#243;n del tama&#241;o ventricular depende de la eficacia&#46; El &#237;ndice de Evans&#44; &#237;ndice del tercer ventr&#237;culo&#44; &#237;ndice de celia media y el &#237;ndice ventricular global disminuyen si la ventriculostomia es eficaz y aumentan en caso de fallo &#40;p&#60;0&#46;05&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusi&#243;n</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En la hidrocefalia secundaria a met&#225;stasis cerebrales la eficacia de una ventriculostomia endosc&#243;pica es menor por una probable implicaci&#243;n de otros mecanismos fisiopatol&#243;gicos&#44; adem&#225;s de una obstrucci&#243;n en la circulaci&#243;n de LCR&#46; La evoluci&#243;n del tama&#241;o ventricular se relaciona con el resultado de la ventriculostomia&#46;</p>"
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        "titulo" => "Summary"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Endoscopic third ventriculostomy is the treatment of choice for non communicating hydrocephalus at our institution&#46; Several factors have been associated with failure of endoscopic third ventriculostomy&#46; The goals of the study have been to evaluate the outcome&#44; the influence of factors theoretically prone to failure of ventriculostomy and the evolution of ventricular size&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Fifty-six patients &#40;mean age 48&#46;5 yrs&#41; treated with an endoscopic third ventriculostomy during the period 1997&#8211;2002 were analysed retrospectively&#46; Hydrocephalus was classified as acute &#40;68&#37;&#41; and chronic forms&#46; Etiology was classified in space-occupying lesions &#40;59&#37;&#41;&#44; primary aqueductal stenosis &#40;34&#37;&#41; and Chiari malformation &#40;7&#37;&#41;&#46; The presence of the following factors theoretically prone to failure was considered&#58; age below one year&#44; history of mielomeningocele&#44; cerebrospinal fluid &#40;CSF&#41; infection&#44; intracranial haemorrhage&#44; radiotherapy&#44; craniotomy and previous treatment of hydrocephalus with a shunt&#46; Ventricular size was measured linearly with four ventricular index pre- and postoperatively&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The global success rate was 71&#46;4&#37; &#40;mean follow-up 26 months&#41;&#46; Endoscopic third ventriculostomy for hydrocephalus secondary to cerebral metastases obstructing CSF pathways was associated with a higher risk of failure &#40;p&#61;0&#46;006&#41;&#46; None of the risk factors considered was associated with a higher risk of failure&#46; The evolution of the ventricular size measured with linear methods is associated with outeome&#46; Evans ratio&#44; third ventricle index&#44; celia media index and ventricular score decreased in patients whose outeome is satisfactory and increased in those cases deemed clinical failures &#40;p&#60;0&#46;05&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The risk of failure increases in patients with cerebral metastases ci&#243;se to CSF pathways&#44; likely due to the concurrence of mechanisms other than obstruction&#46; Changes in ventricular size are associated with outeome&#46;</p>"
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                    0 => array:1 [
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                        "tituloSerie" => "Pediatr Neurosurg"
                        "fecha" => "1998"
                        "volumen" => "28"
                        "paginaInicial" => "236"
                        "paginaFinal" => "240"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9732255"
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                          "autores" => array:5 [
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                            2 => "C&#46; Mallucci"
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                        "paginaFinal" => "78"
                        "link" => array:1 [
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                      "doi" => "10.3171/jns.1999.90.3.0448"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1999"
                        "volumen" => "90"
                        "paginaInicial" => "448"
                        "paginaFinal" => "454"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10067912"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Computer-assissted stereotactic third ventriculostomy in the management of noncommunicating hydrocephalus"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;J&#46; Dalrympe"
                            1 => "P&#46;J&#46; Kelly"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Stereotact Funct Neurosurg"
                        "fecha" => "1992"
                        "volumen" => "59"
                        "paginaInicial" => "105"
                        "paginaFinal" => "110"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1295027"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The relationship between intracranial pressure and size of cerebral ventricles assessed by computed tomography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46;K&#46; Eide"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "2003"
                        "volumen" => "145"
                        "paginaInicial" => "171"
                        "paginaFinal" => "179"
                      ]
                    ]
                  ]
                ]
              ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors for failure of endoscopio third ventriculostomy for obstructive hydrocephalus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46; Fukuhara"
                            1 => "S&#46;J&#46; Vorster"
                            2 => "M&#46;G&#46; Luciano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2000"
                        "volumen" => "46"
                        "paginaInicial" => "1100"
                        "paginaFinal" => "1111"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10807242"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of hydrocephalus with third ventriculocisternostomy&#58; outcome and CSF flowpatterns"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "L&#46;C&#46; Goumnerova"
                            1 => "D&#46;M&#46; Frim"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Neurosurg"
                        "fecha" => "1997"
                        "volumen" => "27"
                        "paginaInicial" => "149"
                        "paginaFinal" => "152"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9548525"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endoscopio third ventriculostomy&#58; outcome analysis of 100 consecutive procedures"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "N&#46;J&#46; Hopf"
                            1 => "P&#46; Grunert"
                            2 => "G&#46; Fr&#237;es"
                            3 => "K&#46;D&#46;M&#46; Resch"
                            4 => "A&#46; Perneczky"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1999"
                        "volumen" => "44"
                        "paginaInicial" => "795"
                        "paginaFinal" => "806"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10201305"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Burr-hole third ventriculo-cisternostomy&#46; An unpopular but effective procedure for treatment of certain forms of occlusive hydrocephalus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H&#46; Jaksche"
                            1 => "F&#46; Loew"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "1986"
                        "volumen" => "79"
                        "paginaInicial" => "48"
                        "paginaFinal" => "51"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neuroendoscopic third ventriculostomy&#46; A practical alternative to extracranial shunts in non-communicating hydroce-phalus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46;F&#46;C&#46; Jones"
                            1 => "B&#46;C&#46;T&#46; Kwok"
                            2 => "W&#46;A&#46; Stening"
                            3 => "M&#46; Vonau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "1994"
                        "volumen" => "61"
                        "paginaInicial" => "79"
                        "paginaFinal" => "83"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The initial treatment of hydrocephalus&#58; An assessment of surgeon&#39;s preferente between third ventriculostomy and shunt insertion"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Kestle"
                            1 => "D&#46; Cochrane"
                            2 => "R&#46; Alisharan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurol Res"
                        "fecha" => "2000"
                        "volumen" => "22"
                        "paginaInicial" => "65"
                        "paginaFinal" => "68"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10672582"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Communicating hydrocephalus secondary to a cardiac tumor compressing the superior vena cava"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46;D&#46; Kollar"
                            1 => "I&#46;H&#46; Johnston"
                            2 => "G&#46;H&#46; Sholler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s003810000269"
                      "Revista" => array:6 [
                        "tituloSerie" => "Childs Nerv Syst"
                        "fecha" => "2001"
                        "volumen" => "17"
                        "paginaInicial" => "117"
                        "paginaFinal" => "120"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11305763"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Imaging correlates of successful endoscopio third ventriculostomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;V&#46; Kulkarni"
                            1 => "J&#46;M&#46; Drake"
                            2 => "D&#46;C&#46; Armstrong"
                            3 => "P&#46;B&#46; Dirks"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.2000.92.6.0915"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "2000"
                        "volumen" => "92"
                        "paginaInicial" => "915"
                        "paginaFinal" => "919"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10839249"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cognitive changes after cerebrospinal fluid shunting in young adults with spina bifida and assumed arrested hydrocephalus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "M&#46; Matar&#243;"
                            1 => "M&#46;A&#46; Poca"
                            2 => "J&#46; Sahuquillo"
                            3 => "A&#46; Cuxart"
                            4 => "J&#46; Iborra"
                            5 => "M&#46;D&#46; de la Calzada"
                            6 => "C&#46; Junqu&#233;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurol Neurosurg Psychiatry"
                        "fecha" => "2000"
                        "volumen" => "68"
                        "paginaInicial" => "615"
                        "paginaFinal" => "621"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10766893"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acquired hydrocephalus associated with superior vena cava syndrome in infants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;F&#46; McLaughlin"
                            1 => "J&#46;D&#46; Loeser"
                            2 => "T&#46;S&#46; Roberts"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s003810050042"
                      "Revista" => array:6 [
                        "tituloSerie" => "Childs Nerv Syst"
                        "fecha" => "1997"
                        "volumen" => "13"
                        "paginaInicial" => "59"
                        "paginaFinal" => "63"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9105737"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Frontal and occipital horn ratio&#58; a linear estimate of ventricular size for multiple imaging modalities in pediatric hydrocephalus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "B&#46;B&#46; O&#8217;Hayon"
                            1 => "J&#46;M&#46; Drake"
                            2 => "M&#46;G&#46; Ossip"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "28730"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Neurosurg"
                        "fecha" => "1999"
                        "volumen" => "29"
                        "paginaInicial" => "245"
                        "paginaFinal" => "249"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9917541"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prospective analysis by computed tomography and long-term outcome of 23 adult patients with chronic idiopathic hydrocephalus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46; Raftopoulos"
                            1 => "N&#46; Massager"
                            2 => "D&#46; Bal&#233;riaux"
                            3 => "J&#46; Deleval"
                            4 => "S&#46; Clarysse"
                            5 => "J&#46; Brotchi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1996"
                        "volumen" => "38"
                        "paginaInicial" => "51"
                        "paginaFinal" => "59"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8747951"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcome analysis of endoscopio III ventriculostomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;M&#46; Scarrow"
                            1 => "E&#46;L&#46; Levy"
                            2 => "L&#46; Pascucci"
                            3 => "A&#46;L&#46; Albright"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Childs Nerv Syst"
                        "fecha" => "2000"
                        "volumen" => "16"
                        "paginaInicial" => "442"
                        "paginaFinal" => "445"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10958555"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Complications of endoscopio third ventriculostomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H&#46;W&#46;S&#46; Schroeder"
                            1 => "W&#46;R&#46; Niendorf"
                            2 => "M&#46;R&#46; Gaab"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.2002.96.6.1032"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "2002"
                        "volumen" => "96"
                        "paginaInicial" => "1032"
                        "paginaFinal" => "1040"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12066903"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endoscopio third ventriculostomy in patients with cerebrospinal fluid infection and&#47;or hemorrhage"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
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                            1 => "G&#46; Cinalli"
                            2 => "A&#46; Grotenhuis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.2002.97.3.0519"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "2002"
                        "volumen" => "97"
                        "paginaInicial" => "519"
                        "paginaFinal" => "524"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12296633"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hydrocephalus in radiation leukoencephalopathy&#58; results of ventriculoperitoneal shunting"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "B&#46; Thiessen"
                            1 => "L&#46;M&#46; DeAngelis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Neurol"
                        "fecha" => "1998"
                        "volumen" => "55"
                        "paginaInicial" => "705"
                        "paginaFinal" => "710"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9605728"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "How effective is endoscopio third ventriculostomy in treating adult hydrocephalus caused by primary aqueductal stenosis&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Tisell"
                            1 => "O&#46; Almstrom"
                            2 => "H&#46; Stephensen"
                            3 => "M&#46; Tullberg"
                            4 => "C&#46; Wikkels&#243;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2000"
                        "volumen" => "46"
                        "paginaInicial" => "104"
                        "paginaFinal" => "111"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10626941"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
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Vol. 15. Núm. 3.
Páginas 248-256 (enero 2004)
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Vol. 15. Núm. 3.
Páginas 248-256 (enero 2004)
Ventriculostomia endoscópica: influencia de factores predisponentes al fallo y evolución del tamaño ventricular
Endoscopic third ventriculostomy: risk factors for failure and evolution of ventricular size
Visitas
4019
D. Santamaría
, I. Onzain, J.A. Blázquez, J.A. Gómez-Moreta, F. Morales
Servicio de Neurocirugía. Hospital Universitario. Salamanca
Este artículo ha recibido
Información del artículo
Resumen
Introducción

La ventriculostomia endoscópica es en nuestro centro el tratamiento de primera elección para la hidrocefalia no comunicante. Hay una serie de factores favorecedores de un fracaso de la intervención. El objetivo de este trabajo ha sido analizar su influencia en nuestra serie.

Material y métodos

Cincuenta y seis pacientes (edad media 48.5 años) han sido tratados mediante ventriculostomia endoscópica durante el periodo 1997–2002. Se han diferenciado formas agudas (68%) y formas crónicas de hidrocefalia. La etiología se clasificó en lesiones ocupantes de espacio (59%), estenosis primaria del acueducto (34%) y malformación de Chiari (7%). Consideramos los siguientes factores predisponentes al fracaso: edad inferior a 12 meses, antecedentes de mielomeningocele, radioterapia, craneotomía, infección de líquido cefalorraquídeo (LCR), hemorragia intracraneal y tratamiento previo de la hidrocefalia con un shunt. Se analizó la evolución de cuatro índices de tamaño ventricular comparando la última imagen postoperatoria con la preoperatoria.

Resultados

Después de un periodo de seguimiento medio de 26 meses, la intervención ha sido efectiva en el 71.4% de los pacientes. La hidrocefalia secundaria a metástasis localizadas en áreas que dificultan la circulación de LCR se asocia con fracaso de la ventriculostomia (p=0.006). Ninguno de los factores predisponentes al fallo ha mostrado relación con el resultado de la intervención. La evolución del tamaño ventricular depende de la eficacia. El índice de Evans, índice del tercer ventrículo, índice de celia media y el índice ventricular global disminuyen si la ventriculostomia es eficaz y aumentan en caso de fallo (p<0.05).

Conclusión

En la hidrocefalia secundaria a metástasis cerebrales la eficacia de una ventriculostomia endoscópica es menor por una probable implicación de otros mecanismos fisiopatológicos, además de una obstrucción en la circulación de LCR. La evolución del tamaño ventricular se relaciona con el resultado de la ventriculostomia.

Palabras clave:
Hidrocefalia
Ventriculostomia endoscópica
Ventrículo
Resultado
Summary
Introduction

Endoscopic third ventriculostomy is the treatment of choice for non communicating hydrocephalus at our institution. Several factors have been associated with failure of endoscopic third ventriculostomy. The goals of the study have been to evaluate the outcome, the influence of factors theoretically prone to failure of ventriculostomy and the evolution of ventricular size.

Material and methods

Fifty-six patients (mean age 48.5 yrs) treated with an endoscopic third ventriculostomy during the period 1997–2002 were analysed retrospectively. Hydrocephalus was classified as acute (68%) and chronic forms. Etiology was classified in space-occupying lesions (59%), primary aqueductal stenosis (34%) and Chiari malformation (7%). The presence of the following factors theoretically prone to failure was considered: age below one year, history of mielomeningocele, cerebrospinal fluid (CSF) infection, intracranial haemorrhage, radiotherapy, craniotomy and previous treatment of hydrocephalus with a shunt. Ventricular size was measured linearly with four ventricular index pre- and postoperatively.

Results

The global success rate was 71.4% (mean follow-up 26 months). Endoscopic third ventriculostomy for hydrocephalus secondary to cerebral metastases obstructing CSF pathways was associated with a higher risk of failure (p=0.006). None of the risk factors considered was associated with a higher risk of failure. The evolution of the ventricular size measured with linear methods is associated with outeome. Evans ratio, third ventricle index, celia media index and ventricular score decreased in patients whose outeome is satisfactory and increased in those cases deemed clinical failures (p<0.05).

Conclusión

The risk of failure increases in patients with cerebral metastases cióse to CSF pathways, likely due to the concurrence of mechanisms other than obstruction. Changes in ventricular size are associated with outeome.

Key words:
Hydrocephalus
Endoscopic third ventriculostomy
Ventricle
Outeome

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