Delayed refractory hyperventilation following endoscopic third ventriculostomy in a 5-year-old boy

Area of Science:

• Pediatric Neurology
• Neurosurgery
• Critical Care Medicine

Background:

• Endoscopic third ventriculostomy (ETV) is a neurosurgical procedure to treat hydrocephalus.
• Hyperventilation is a known but rare complication post-neurosurgery.
• Delayed onset and intractable hyperventilation are exceptionally uncommon sequelae.

Observation:

• A 5-year-old boy presented with delayed onset intractable hyperventilation.
• The symptoms occurred after undergoing an endoscopic third ventriculostomy.
• This presentation is unusual in the pediatric population.

Findings:

• The patient developed severe, persistent hyperventilation.
• The proposed etiology for this rare phenomenon is discussed.
• This is the first reported case in a child, with prior reports limited to adults.

Implications:

• This case expands the known spectrum of complications following ETV to include pediatric patients.
• It suggests the need for increased vigilance for delayed respiratory complications in children post-ETV.
• Further research may be warranted to understand the pathophysiology and risk factors in pediatric populations.