Amenorrhea complicating endoscopic third ventriculostomy in the pediatric age group

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Steven W Hwang1, George Al-Shamy, William E Whitehead

  • 1Division of Pediatric Neurosurgery, Texas Children's Hospital, Department of Neurosurgery, Baylor College of Medicine, Houston, Texas 77030, USA.

Journal of Neurosurgery. Pediatrics
|September 3, 2011
PubMed

Insights

Endoscopic third ventriculostomy (ETV) for obstructive hydrocephalus may cause delayed endocrine issues like amenorrhea. This study highlights two cases in adolescent girls, suggesting potential underreporting of these serious complications.

Area of Science:

  • Pediatric Neurosurgery
  • Pediatric Endocrinology
  • Neuroendocrinology

Background:

  • Endoscopic third ventriculostomy (ETV) is a primary treatment for obstructive hydrocephalus in children.
  • The procedure involves creating an opening in the floor of the third ventricle, near the hypothalamic-pituitary axis.
  • Potential endocrine complications are recognized but may be underreported due to delayed onset and attribution.

Observation:

  • This study details two adolescent girls who developed amenorrhea after ETV for obstructive hydrocephalus.
  • Correlative laboratory findings were analyzed in conjunction with the clinical case descriptions.
  • The onset of amenorrhea occurred months to years post-procedure.

Findings:

  • The cases illustrate a potential link between ETV and the development of secondary amenorrhea.
  • The tuber cinereum's proximity to the surgical site is implicated in hypothalamic-pituitary dysfunction.
  • Laboratory findings support endocrine disruption following the procedure.

Implications:

  • Increased awareness and monitoring for endocrine sequelae after ETV are crucial.
  • Further research is needed to elucidate the mechanisms and prevalence of ETV-associated endocrine dysfunction.
  • This highlights the importance of a multidisciplinary approach in managing pediatric hydrocephalus patients.

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