This information will help you learn about your endoscopic third ventriculostomy (ven-TRI-cu-LUS-to-my), or ETV. In this resource, the words “you” and “your” mean either you or your child.
ETV is a surgery to drain extra cerebrospinal fluid (CSF) from your brain. CSF is a liquid that is made in the ventricles (hollow spaces) in your brain.
CSF protects your brain and spinal cord by acting like a cushion. It also brings nutrients throughout your brain and carries waste away. You’re making new CSF all the time.
CSF flows from your ventricles, around your brain and spinal cord, and into your bloodstream. If extra CSF builds up in your ventricles, it can cause hydrocephalus (HY-droh-SEH-fuh-lus).
Hydrocephalus is when extra CSF makes your ventricles bigger and puts pressure on your brain (see Figure 1). Hydrocephalus can happen if the flow of CSF is blocked. It also happens if not enough CSF is absorbed into your bloodstream.
Figure 1. Brain with and without hydrocephalus
About your ETV surgery
Your ETV surgery will be done in the operating room while you’re asleep. Your nurse may shave a small amount of hair near where the incision (surgical cut) will be. They will not shave your entire head.
Figure 2. Endoscopic third ventriculostomy (ETV)
During your surgery, your surgeon will make a tiny hole in the third ventricle of your brain. This will let the extra CSF drain into another area of your brain where it will be absorbed (see Figure 2). To learn more, read the resource About Your Endoscopic Third Ventriculostomy (ETV) Surgery at MSK Kids.
Safety guidelines after your ETV surgery
Wear MedicAlert® jewelry
You should always wear a MedicAlert bracelet or necklace that says you have hydrocephalus with an ETV. This will help emergency service workers care for you if you’re ever badly ill or hurt and need medical help.
You can buy a MedicAlert bracelet or necklace at most drug stores. You can also ask a member of your care team for an application. Visit the MedicAlert website at www.medicalert.org to learn more.
Wear a helmet, if needed
You can go back to doing all your usual activities after your surgery. Wear a helmet to lower your risk of head injury, if needed. Ask your surgeon for specific guidelines on wearing a helmet.
Continue with imaging scans
You can have any imaging scan done after your surgery. This includes a magnetic resonance imaging (MRI), computed tomography (CT), or X-ray scan. You do not need to take any special care.
When to call your healthcare provider
Call your healthcare provider if you have any of the following.
- Increased head size and bulging soft spot in baby’s head.
- A headache that does not get better after resting or taking medicine.
- Vomiting (throwing up) with little or no nausea (feeling like you’re going to throw up).
- Fatigue (feeling unusually tired or weak).
- Irritability (becoming easily frustrated or annoyed).
- Personality changes (not acting like your normal self).
- Problems with thinking and memory (such as confusion).
- Trouble with balance or walking.
- Trouble waking up or staying awake.
- Trouble holding in your urine (pee).
- Seizures (uncontrollable shaking).
- High pitched cry in babies.
- Trouble eating.
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Problems seeing, such as:
- Blurred vision
- Double vision
- Vision loss
- Eyes that turn downward (also called sunsetting)
These warning signs can appear quickly. If your child has any of these signs or symptoms, call their healthcare provider right away.
If you cannot wake your child, call 911 or go to the nearest emergency room right away.
