About Your Endoscopic Third Ventriculostomy (ETV) for Pediatric Patients

This information will help you learn about your endoscopic third ventriculostomy (ETV). For the rest of this resource, the words “you” and “your” refer to you or your child.

ETV is a surgery to drain extra cerebrospinal fluid (CSF) from your brain. CSF is the fluid that surrounds your brain and spinal cord. It’s made in the ventricles (hollow spaces) inside your brain. CSF protects your brain and spinal cord by acting like a cushion. However, when you have too much of it, it puts pressure on your brain and skull. This extra fluid makes your ventricles grow bigger (see Figure 1). This is called hydrocephalus (hi-druh-sef-uh-lee) (see Figure 1).

Figure 1: Brain with and without hydrocephalus

Your ETV surgery will be done in the operating room while you’re asleep. Once you’re asleep, the hair along your incision (surgical cut) line will be shaved. Your entire head won’t be shaved. A tiny hole will be made in the third ventricle of your brain to allow the extra CSF to drain into another area of your brain to be absorbed (see Figure 2).

Figure 2: ETV

For more information, ask your nurse for the resource Patient Guide to Pediatric Endoscopic Third Ventriculostomy (ETV) Surgery, or search for it on www.mskcc.org/pe

Below are some common questions that people have about an ETV.

Are there any restrictions on my activities?

No. You can resume all of your normal activities after your surgery.

Remember to wear a helmet to decrease the risk of head injury, if needed. Ask your neurosurgeon for specific guidelines on wearing a helmet.


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Do I need to take any precautions if I have magnetic resonance imaging (MRI)?

No. The magnet in the MRI scanner won’t affect your ETV.

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What other precautions do I need to take?

You should always wear a MedicAlert® bracelet or necklace stating that you have hydrocephalus with an ETV. If you’re ever seriously ill or hurt and need medical help, it will let emergency services workers know about your ETV. You can purchase this type of bracelet or necklace at most drug stores. For more information, visit the MedicAlert website at: www.medicalert.org

You should also carry a wallet card at all times that states you have hydrocephalus with an ETV. Your nurse will give you a wallet card to fill out.

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When should I call my doctor or nurse practitioner (NP)?

Call your doctor or NP if you’re having any of the following signs and symptoms:

  • A temperature of 100.4° F (38.0° C) or higher
  • Vomiting with little or no nausea
  • A headache that doesn’t go away
  • Vision problems (blurry, double vision, or loss of vision)
  • Irritability (easily frustrated or annoyed)
  • Fatigue (feeling unusually tired or weak)
  • Personality changes
  • Loss of coordination or balance
  • A bulging soft spot on an infant’s head
  • Trouble waking up or staying awake
  • Decrease in school performance

These warning signs can appear quickly. If you have any of these signs or symptoms, call your doctor or NP right away.

If you can’t wake your child, call 911, or go to the nearest emergency room right away.

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