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, our use of the words “you” and “your” refers to you or your child.

ETV is a surgery to drain extra fluid that circulates around the brain and spinal cord. This fluid is called cerebrospinal fluid (CSF). It is found in the ventricles of the brain and the spinal canal. If too much CSF is in the ventricles, it puts pressure on the brain and skull. This is called hydrocephalus (see Figure 1).

Figure 1: Brain with and without hydrocephalus

Your ETV surgery will be done in the operating room while you are asleep. Your nurse will give you more information about the surgery. Once you are asleep, the hair along your incision line will be shaved. Your entire head will not be shaved. A tiny hole will be made in the third ventricle of the brain to allow the excess CSF to drain into another area of the brain to be absorbed (see Figure 2).

Figure 2: ETV

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

Are there any restrictions on my activities?

There are no restrictions on your activities. 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 will not 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 are ever seriously ill or hurt and need medical help, it will inform emergency services workers 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?

Call your doctor or nurse practitioner if you are having any of the following signs and symptoms that your ETV is not working properly or you have an infection:

  • A temperature of 100.4° F (38.0° C) or higher
  • Vomiting with little or no nausea
  • A constant, unrelieved headache
  • Vision problems (blurry, double vision, or loss of vision)
  • Irritability
  • Fatigue
  • Personality changes
  • Loss of coordination or balance
  • A bulging soft spot on an infant’s head
  • Difficulty waking up or staying awake
  • Decrease in school performance

These warning signs can appear quickly. If any of these signs or symptoms develop, call your doctor or nurse practitioner immediately. 

If you cannot wake your child, call 911, or go to the nearest emergency room immediately.

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