Management of XXXX associated with occipital encephalocoele using endoscopic third ventriculostomy: report of two cases.

@entity3570 @entity1 @entity281 @entity1276
BACKGROUND: Occipital encephalocoele is the most common cranial @entity3570 in the western hemisphere and is often complicated by @entity1276 . Management of @entity1276 and reducing the CSF pressure is crucial in preventing dehiscence at the site of the encephalocoele repair. METHODS: Two female @entity1 had presented with occipital encephalocoeles. The first @entity1 (aged 42 days) had undergone repair of the occipital encephalocoele and then developed @entity1276 with recurrence of the encephalocoele. The second @entity1 (aged 12 months) had @entity1276 associated with an occipital encephalocoele at initial presentation.Both the @entity1 underwent endoscopic third ventriculostomy (ETV) through a right frontal burr hole. In the first @entity1 , ETV was performed after shunt dysfunction at the age of 9 months. Because she presented with recurrence of the encephalocoele 15 months later, a repeat endoscopic third ventriculostomy was performed. She required a ventriculoperitoneal shunt during the same admission because of the early failure of the ventriculostomy. In the second @entity1 , it was performed before the encephalocoele repair, both ETV and the repair being conducted under the same anesthesia. ETV was performed using a rigid scope and the perforation in the third ventricular floor was enlarged using a No. 4 Fogarty catheter. RESULTS: The first @entity1 had no recurrence of encephalocoele at follow-up of 10 months but she presented with recurrence of the occipital encephalocoele after 15 months. The second @entity1 had no evidence of recurrence at follow-up after 16 months. The lateral and third ventricular volumes had decreased in both the @entity1 at initial follow-up. CONCLUSION: ETV can be an effective treatment option for encephalocoele-associated @entity1276 , even in @entity1 under the age of 1 year. It may obviate the need for placement of CSF shunts that have a risk of @entity281 . However, delayed failure of ETV may occur as seen in our first @entity1 , indicating the need for careful and long-term follow-up.
