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[Spontaneous third ventriculostomy in obstructive hydrocephalus with composed aetiology: a case report]
Krzysztof Stachura1, Marek Moskała
1Klinika Neurochirurgii i Neurotraumatologii UJ CM, ul. Botaniczna, Kraków, Poland. kkstach@poczta.onet.pl
Neurologia I Neurochirurgia Polska
|April 2, 2010
Summary
Spontaneous third ventriculostomy (TV) is rare but should be considered in obstructive hydrocephalus cases. This study details one such rare instance in a patient undergoing neuroendoscopic surgery.
Area of Science:
- Neurosurgery
- Neurology
- Medical Imaging
Background:
- Third ventriculostomy (TV) is a primary neuroendoscopic procedure for obstructive hydrocephalus.
- Restoring physiological cerebrospinal fluid circulation is the goal of TV.
- Spontaneous TV is an exceptionally rare occurrence documented in limited case reports.
Observation:
- A case of spontaneous third ventriculostomy was identified in a patient undergoing neuroendoscopic surgery.
- Intraoperative findings revealed an enlarged infundibulo-mammillary triangle with perforation.
- Postoperative improvement was partial, with unchanged radiological appearance initially.
Findings:
- The patient experienced recurrent hydrocephalus symptoms three weeks post-procedure.
- An infusion test indicated increased cerebrospinal fluid outflow resistance.
- A ventriculo-peritoneal shunt implantation resulted in stable clinical improvement.
Implications:
- Spontaneous TV is a rare but significant finding in neuroendoscopic procedures.
- Consideration of spontaneous TV is crucial during patient selection for TV.
- This phenomenon may influence management strategies for obstructive hydrocephalus.
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