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Surgical treatment of long-standing overt ventriculomegaly in adults (LOVA)

Ved, Ronak, Leach, Paul and Patel, Chirag 2017. Surgical treatment of long-standing overt ventriculomegaly in adults (LOVA). Acta Neurochirurgica 159 (1) , pp. 71-79. 10.1007/s00701-016-2998-7

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Background Longstanding overt ventriculomegaly in adults (LOVA) is characterised by chronic hydrocephalus presumed to begin during infancy, but arresting before becoming clinically detectable. Later in life clinical features of hydrocephalus ensue, typically in the 5th or 6th decades. Only a relatively small number of LOVA case series have been published, and ambiguity remains regarding optimal management. This case series describes a series of patients with LOVA treated successfully at a single neurosurgical institution using endoscopic third ventriculostomy (ETV). Methods A series of 14 patients were diagnosed with LOVA using established clinical and radiological criteria. All patients underwent an ETVand their clinical conditions were followed up for up to 5 years post-operatively. Results Fourteen patients (100 %) reported either improvement or halt of progression in their presenting symptoms 3 months after ETV; 93 % of patients (n = 13) did not require any further surgical intervention. One patient (7 %) reported deterioration in symptoms beyond 3 months post-operatively, which necessitated further surgery (ventriculoperitoneal shunt). These promising outcomes after ETV are mirrored in numerous other LOVA case series. Other works have analysed the value of CSF shunting procedures in LOVA, with mixed results. A direct, prospective comparison of outcomes after shunt procedures and ETV, with a specific focus on LOVA patients, is yet to be completed. A minority of patients fail to respond, or develop recurrence of symptoms, months or years after initial surgical intervention

Item Type: Article
Date Type: Publication
Status: Published
Schools: Postgraduate Medical and Dental Education
ISSN: 00016268
Date of First Compliant Deposit: 30 January 2017
Date of Acceptance: 13 October 2016
Last Modified: 15 Jun 2023 05:53

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