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Endoscopic Third Ventriculostomy (ETV) and Endoscopic Third Ventriculostomy with Choroid Plexus Cauterization (ETV/CPC)

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A second treatment option for hydrocephalus is a surgical procedure called endoscopic third ventriculostomy (ETV). This same ETV procedure with the addition of choroid plexus cauterization is available for infants. In the ETV procedure, an endoscope is used to puncture a membrane in the floor of the third ventricle creating a pathway for CSF flow within the cavities in the brain. This approach is an important alternative to shunting for obstructive hydrocephalus and may be useful in other cases as well.

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The third treatment option involves the addition of choroid plexus cauterization with endoscopic third ventriculostomy in infants. The neurosurgeon uses a device to burn or cauterize tissue from the choroid plexus. The choroid plexus is a network of vessels in the ventricles of the brain where cerebrospinal fluid is produced.

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The success rate for ETV or ETV/CPC depends upon patient factors such as age, cause of hydrocephalus, and whether there is scarring in the fluid space below the floor of the third ventricle. For some patients, the chance for success of the ETV may be up to 90%; however, for others, ETV – with the addition of CPC for infants – may not be recommended because the chances for success are sufficiently low. Your neurosurgeon should be able to provide you with a reliable estimate of the likelihood for success in your particular situation prior to the operation. It’s critical that parents and patients understand that ETV is not always a permanent cure for hydrocephalus. Candid communication with your physician regarding the definition of success is important when considering ETV.

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Information provided by Hydrocephalus Association (http://www.hydroassoc.org

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