Endoscopic antegrade aqueductoplasty and stenting with panventricular catheter in management of trapped fourth ventricle in patients with inadequately functioning supratentorial shunt.

Background: Trapped fourth ventricle (TFV) usually develops as a complication of supratentorial ventricular CSF shunting, especially when hydrocephalus is caused by intraventricular hemorrhage and/or infection. This study aimed to assess the feasibility of endoscopic aqueduct stenting using a single refashioned shunt tube to treat cases presenting with both TFV and shunt malfunction.
Methods: We retrospectively collected and analyzed data from patients presenting with TFV and supratentorial shunt malfunction who underwent endoscopic aqueduct stenting using a refashioned shunt tube. All cases were treated at our institution between January 2010 and July 2019. The surgical technique is described.
Results: Eighteen patients were enrolled in our study. There were ten males and eight females. The mean age was 11.2 years (range = 1-33 years). Headache, nausea, and vomiting were the most common clinical presentations. The mean duration of follow-up was 22.1 months (range = 6-60 months). All cases showed clinical and radiological improvement after surgery.
Conclusion: Endoscopic antegrade aqueductoplasty and stenting with the refashioned panventricular shunt catheter are an adequate treatment option for both TFV and supratentorial shunt malfuncion.
Competing Interests: There are no conflicts of interest.
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