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Increasing chronic subdural hematoma after endoscopic III ventriculostomy
L Beni-Adani1, V Siomin, Y Segev
1Division of Pediatric Neurosurgery, Dana Children's Hospital, Tel-Aviv Sourasky Medical Center, Israel.
Summary
Endoscopic third ventriculostomy (ETV) is a safe hydrocephalus treatment. A rare case shows chronic subdural hematoma (ChSDH) can still occur after ETV due to significant intracranial pressure decrease.
Area of Science:
- Neurosurgery
- Neurology
- Medical Imaging
Background:
- Endoscopic third ventriculostomy (ETV) is a primary treatment for noncommunicating hydrocephalus.
- ETV is favored over shunts for avoiding complications like overdrainage.
Observation:
- A patient with aqueductal stenosis developed chronic subdural hematoma (ChSDH) after ETV and shunt removal.
- The ChSDH was large and asymptomatic initially but grew, causing mass effect.
Findings:
- This case highlights a rare instance of ChSDH development post-ETV.
- Unlike shunt-related ChSDHs, this occurred despite ETV and shunt removal.
Implications:
- A significant drop in intracranial pressure after ETV may precipitate ChSDH.
- Neurosurgeons should consider ChSDH in patients with decreased intracranial pressure post-ETV.
