Gillespie, Conor S, Richardson, George E, Mustafa, Mohammad A, Evans, Daisy, George, Alan M, Islim, Abdurrahman I, Mallucci, Conor 
ORCID: 0000-0002-5509-0547, Jenkinson, Michael D ORCID: 0000-0003-4587-2139 and McMahon, Catherine J
(2022)
How should we treat long-standing overt ventriculomegaly in adults (LOVA)? A retrospective cohort study.
NEUROSURGICAL REVIEW, 45 (5).
pp. 3193-3200.
Abstract
Long-standing overt ventriculomegaly in adults (LOVA) is a heterogenous group of conditions with differing presentations. Few studies have evaluated success rates of available surgical treatments, or ascertained the natural history. There is a need to assess the efficacy of both endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunt (VPS) as first-line treatments. We conducted a retrospective, single-centre study of adults with LOVA at a tertiary neurosurgery centre in England, UK, aiming to identify presentation, management strategy, and outcome following treatment. A total of 127 patients were included (mean age 48.1 years, 61/127 male). Most patients were symptomatic (73.2%, n = 93/127, median symptom duration 10 months). The most common symptoms were gait ataxia, headache, and cognitive decline (52.8%, 50.4%, and 33.9%, respectively). Fourteen patients had papilloedema. Ninety-one patients (71.7%) underwent surgery (84 ETV, 7 VPS). Over a median follow-up of 33.0 months (interquartile range [IQR] 19.0-65.7), 82.4% had a clinical improvement after surgery, and 81.3% had radiological improvement. Clinical improvement rates were similar between ETV and VP shunt groups (82.1% vs 85.7%, p = 0.812). Surgical complication rates were significantly lower in the ETV group than the VP shunt group (4.8% vs 42.9%, p < 0.001). Of the patients treated surgically, 20 (22.0%) underwent further surgery, with 14 patients improving. This study demonstrates the efficacy of ETV as a first-line treatment for LOVA.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | LOVA, Long-standing overt ventriculomegaly in adults, Chronic hydrocephalus, Arrested hydrocephalus, Aqueduct stenosis, Hydrocephalus |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 08 Jul 2022 11:35 |
| Last Modified: | 18 Jan 2023 20:56 |
| DOI: | 10.1007/s10143-022-01812-5 |
| Open Access URL: | https://link.springer.com/article/10.1007/s10143-0... |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3158000 |
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