ETV failure (stoma closure)

What it is

ETV failure is the return of hydrocephalus after an endoscopic third ventriculostomy (ETV), meaning the procedure no longer adequately controls the CSF buildup. A common reason is that the stoma (the opening created in the floor of the third ventricle) narrows or closes.

Understanding ETV failure (stoma closure)

While a successful ETV can provide durable control of hydrocephalus, in some cases it fails — often because the stoma scars over and closes, so CSF can no longer bypass the blockage. ETV failure is more likely in certain situations, such as in very young infants or with causes like post-hemorrhagic or post-infectious hydrocephalus (factors captured in the ETV Success Score). Most ETV failures occur within the first months, though later failures can happen, which is why ongoing follow-up and knowing the warning signs are important. When an ETV fails, options include repeating the ETV (if appropriate) or placing a shunt. Understanding ETV failure helps set expectations and underscores the need for follow-up after an ETV.

Why it matters

Understanding ETV failure helps families see that an ETV can stop working — often because the opening closes — and why follow-up and recognizing warning signs remain important, with options including a repeat ETV or a shunt.