Cognitive improvement after endoscopic third ventriculostomy surgery in long-standing overt ventriculomegaly in adults

J Neurosurg 142:875–883, 2025

Endoscopic third ventriculostomy (ETV) significantly improves long-term memory and visuospatial skills in patients with long-standing overt ventriculomegaly in adults (LOVA), especially those with higher premorbid IQ. The study highlights the role of cognitive reserve in facilitating cognitive recovery post-surgery.

• Endoscopic third ventriculostomy (ETV) surgery leads to cognitive improvement in patients with long-standing overt ventriculomegaly in adults (LOVA), particularly in long-term memory and visuospatial skills.

• Cognitive reserve (CR) plays a crucial role in predicting cognitive recovery post-surgery, with higher premorbid IQ linked to better outcomes.

• LOVA is a chronic form of hydrocephalus that becomes symptomatic in adulthood, often characterized by cognitive deficits and gait disturbances.

• ETV is favored over ventriculoperitoneal shunt (VPS) due to lower complication rates, making it the preferred treatment option.

• Preoperative cognitive profiles of LOVA patients show deficits primarily in long-term memory and visuospatial skills, while other cognitive domains remain unaffected.

• Postoperative improvements are significant and sustained over time, with the majority of patients reporting enhanced cognitive function and quality of life.

• Symptom duration does not hinder the efficacy of ETV, and longer symptom history may lead to better outcomes in visuospatial skills.