神经内窥镜三脑室造瘘术治疗小儿脑积水

目的：介绍神经内窥镜三脑室造瘘术治疗小儿脑积水方法。方法：男8例，女2例，年龄5个月至11岁，平均33个月。CT、MRI及同位素^99Tcm-DTPA脑池显像显示为非脑脊液吸收障碍性脑积水。神经内窥镜从侧脑室经孟氏孔进入三脑室，在乳头小体前言三脑室底最薄处造一瘘口与脚间 池相通。结果：术后随访3－6个月，所有患儿症状均有改善。结论：神经内窥镜行三脑室造瘘术非脑脊液吸收障碍性脑积水是一种有效的微创手术。

Endoscopic third ventriculostomy to treat hydrocephalus in children

Objective To elucidate the indication and surgical technique of endoscopic third ventriculostomy in the surgical treatment for hydrocephalus. Methods Ten patients (male 8, female 2 )with hydrocephalus were admitted. Their age ranged from 5 months to 11years (mean, 33months). Hydrocephalus was caused by stenosis of aqueduct cerebri (2), space occupying lesions (2), post inflammation (2), Chiari malformation (2), intraventricular hemorrhage (1), and obstructive hydrocephalus of unknown origin (1). CT, MRI and 99 Tcm DTPA examinations showed obstructed hydrocephalus with normal absorption of cerebral spinal fluid (CSF). The endoscope was inserted via Monro's foramen into the third ventricle, creating an opening in the floor of third ventricle into interpeduncular cistern.Results All patients have been followed up with a period from 3 to 6 months and had improvements in the clinical signs and ventricle sizes without bleeding, infection or neurologic complications.Conclusion Endoscopic third ventriculostomy is a safe, effective and mini invasive method for obstructive hydrocephalus that CSF absorption is normal.