Endocrine evaluation after endoscopic third ventriculostomy (ETV) in children |
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Authors: | M J Fritsch M Bauer C J Partsch W G Sippell H M Mehdorn |
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Institution: | 1.Department of Neurosurgery,Universit?tsklinikum Schleswig-Holstein,Kiel,Germany;2.Department of Neurosurgery,Ernst-Moritz-Arndt Universit?t,Greifswald,Germany;3.Department of Pediatrics,Universit?tsklinikum Schleswig-Holstein,Kiel,Germany |
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Abstract: | Objective Endoscopic third ventriculostomy (ETV) is a standard procedure for the treatment of obstructive hydrocephalus in children.
Main part of the procedure is the perforation of the third ventricle floor (tuber cinereum). This structure is part of the
hypothalamic–pituitary neuronal network of cerebral endocrine regulation. There are no systematic data available about the
endocrine status after ETV in children.
Materials and methods We examined 20 children who had undergone ETV. Examination included laboratory tests (adrenocorticotropic hormone, prolactin,
insulin-like growth factor 1 IGF-1], IGF-binding protein 3 IGFBP-3], fT3, fT4, thyroid-stimulating hormone TSH], serum
osmolarity, electrolytes, glucose, urea, follicle-stimulating hormone FSH] and luteinizing hormone LH], and testosterone
in selected patients), measurement of weight, height, and head circumference, and physical examination. The study was approved
by the Ethics Committee of the Medical Faculty of Kiel University.
Results In seven patients, prolactin was moderately elevated. One patient demonstrated a significantly increased prolactin (56.3 ng/ml).
In all eight patients, this was the only laboratory value that was out of the normal range; all other parameters were normal.
Three other patients showed one abnormal parameter (decrease in FSH and LH, increase in TSH, decrease in IGF-1 and IGFBP-3).
In nine patients, weight or height was not within the 3rd to 97th centiles for age.
Discussion and conclusion More patients than expected demonstrated endocrine laboratory abnormalities. However, there was no clinical relevance in any
of the studied patients. It remains inconclusive whether ETV contributes to the abnormalities of prolactin levels or to other
endocrine parameters in pediatric patients. Longitudinal studies are necessary to delineate the effect of ETV on endocrine
regulation.
Presented at the Third World Conference of the International Study Group on Neuroendoscopy (ISGNE), Marburg, Germany, 15–18
June 2005. |
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Keywords: | Endoscopic third ventriculostomy Tuber cinereum Prolactin |
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