Endoscopic Third Ventriculostomy with Cystoventricular Stent Placement in the Management of Dandy-Walker Malformation: Technical Case Report of Three Patients

Aaron Mohanty, Thomas H. Milhorat, Robin P. Humphreys, Leslie N. Sutson, Alan R. Cohen

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

OBJECTIVE AND IMPORTANCE: Dandy-Walker malformation has conventionally been managed with placement of cystoperitoneal or ventriculoperitoneal shunts. However, associated aqueductal obstruction requires simultaneous drainage of both the supratentorial and infratentorial compartments. CLINICAL PRESENTATION: Three children with Dandy-Walker malformation and aqueductal obstruction were managed with endoscopic third ventriculostomy and placement of a stent from the third ventricle to the posterior fossa cyst. INTERVENTION: After an endoscopic third ventriculostomy was performed, the stent was placed from the third ventricle to the posterior fossa cyst through the thinnest part of the posteroinferior wall of the aqueduct. There was no operative morbidity. In one patient, the stent was malpositioned, requiring a repositioning. The endoscopic third ventriculostomy was successful in two patients, whereas it failed in one, requiring a ventriculoperitoneal shunt placement. CONCLUSION: Cystoventricular stent placement with endoscopic third ventriculostomy is a promising alternative in patients with Dandy-Walker malformation with aqueductal obstruction.

Original languageEnglish (US)
Pages (from-to)1223-1229
Number of pages7
JournalNeurosurgery
Volume53
Issue number5
DOIs
StatePublished - Nov 2003
Externally publishedYes

Keywords

  • Aqueductal stenting
  • Dandy-Walker malformation
  • Endoscopic third ventriculostomy
  • Hydrocephalus

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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