• Fei Wang, Xiao-Yan Yao, Zhi-Rong Zou, Hua-Lin Yu, and Tao Sun.
• Second Department of Neurosurgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
• World Neurosurg. 2017 Feb 1; 98: 6-13.

BackgroundPyogenic cerebral ventriculitis is a debilitating form of intracranial infection with an unfavorable outcome as a result of lack of experience in surgical management.ObjectiveTo study retrospectively a group of pyogenic cerebral ventriculitis patients managed by neuroendoscopic surgery (NES).MethodsThe standard intraventricular protocols of NES to treat this disease included 1 or more of the following: 1) obliteration of debris, 2) evidence of microbial infection, 3) septomy, 4) incision of the septation, or 5) monitoring catheter insertion. Modified external ventricular drainage EVD (mEVD) was combined with NES when intraventricular debris and bacterial plaques could not be evacuated completely. Subsequent surgical treatment strategies depended on the clinical manifestation, cerebrospinal fluid analysis, and mEVD blockage tests approximately 3 weeks after the last NES.ResultsForty-one patients, who were distributed in 7 hospitals and underwent NES, were included. Five patients received 1 NES, 18 received 2, 16 received 3, and 2 received 4. mEVD was performed in all patients, and mean mEVD duration in the hospital was 27.6 days. At discharge, 15 patients were cured, 15 were cured but ventriculoperitoneal shunt dependent, 9 were mEVD dependent, and 2 died (mean modified Rankin Scale score was 2.48). Two mEVD-dependent patients died, and no other outcomes changed during postoperative follow-up (mean modified Rankin Scale score, 2.67).ConclusionsThe results suggest a relatively favorable outcome for management of pyogenic cerebral ventriculitis by NES. The techniques and strategies are practical and should be applied more extensively.Copyright © 2016 Elsevier Inc. All rights reserved.

27 keywords...

hide…