Long-term resolution of acute, obstructive, triventricular hydrocephalus by endoscopic removal of a third ventricular hematoma without third ventriculostomy : Case report and review of the literature

• Published in: Journal of neurosurgery Vol. 102; no. 5; pp. 930 - 934
• Main Authors: BARBAGALLO, Giuseppe M. V, PLATANIA, Nunzio, SCHONAUER, Claudio
• Format: Journal Article
• Language: English
• Published: Park Ridge, IL American Association of Neurological Surgeons 01-05-2005
• Subjects: Acute Disease; Adult; Biological and medical sciences; Endoscopy - methods; Female; Hematoma - complications; Hematoma - surgery; Humans; Hydrocephalus - etiology; Hydrocephalus - surgery; Medical sciences; Neurosurgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Nervous system diseases; hydrocephalus; Cerebral ventricle; Intracerebral; Hemorrhage; Cerebral disorder; Drainage; Case study; intracerebral hemorrhage; Exeresis; intraventricular hemorrhage; Bypass; external ventricular drainage; Surgery; Ventriculostomy; Central nervous system disease; Hematoma; third ventriculostomy; Endoscopy; Hydrocephaly
• ISSN: 0022-3085
• DOI: 10.3171/jns.2005.102.5.0930

The authors describe a new extension of the use of neuroendoscopy beyond that which is ordinarily performed. The authors report on the resolution of acute, obstructive, triventricular hydrocephalus in a 42-year-old woman with hypertensive caudate hemorrhage that migrated into the ventricular system. The patient underwent emergency endoscopic removal of a third ventricular hematoma, which was obstructing the orifice of the aqueduct, and restoration of cerebrospinal fluid (CSF) flow but no third ventriculostomy. The authors believe that this is the first such case to be reported. In selected cases of third ventricular hemorrhage, endoscopic removal of the intraventricular hematoma may represent a useful and effective treatment option even in emergency conditions as well as a better alternative to prolonged CSF external ventricular drainage. A reduction in the duration of hospitalization is a beneficial consequence. The authors assert that third ventriculostomy is not always needed.