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Related Concept Videos

Cranial Nerves: Types Part I01:14

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Related Experiment Video

Updated: Mar 20, 2026

Author Spotlight: A Single-Entry Point Endoscopic Intraventricular Approach for Third Ventriculostomy and Pineal Biopsy
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A frontal external ventricular drain causing a third cranial nerve palsy.

A A Razak1, V Arzoglou1

  • 1a Department of Neurosurgery , Hull Royal Infirmary , Anlaby Road , Hull , HU3 2JZ , United Kingdom of Great Britain and Northern Ireland.

British Journal of Neurosurgery
|June 1, 2016
PubMed
Summary

A colloid cyst caused acute hydrocephalus, requiring external ventricular drains (EVDs). A complication of third nerve palsy resolved after repositioning an EVD tip, highlighting the importance of accurate drain placement.

Keywords:
Cerebrospinal fluid drainagecomplicationscranial nervecysthydrocephalusthird nerve palsy

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Area of Science:

  • Neurosurgery
  • Neurology
  • Medical Imaging

Background:

  • Acute hydrocephalus is a critical condition often necessitating neurosurgical intervention.
  • Colloid cysts are a known cause of obstructive hydrocephalus.
  • External ventricular drains (EVDs) are used to manage cerebrospinal fluid pressure.

Observation:

  • A patient with hydrocephalus secondary to a colloid cyst developed a third nerve palsy post-operatively.
  • Cranial imaging revealed the tip of an external ventricular drain (EVD) positioned near the oculomotor nerve (CN III).

Findings:

  • The third nerve palsy resolved completely upon slight withdrawal of the EVD.
  • This suggests a direct mechanical effect of the EVD on the third cranial nerve.

Implications:

  • Accurate placement and monitoring of EVDs are crucial to prevent neurological complications.
  • Subtle EVD misplacement can lead to significant cranial nerve deficits.
  • This case underscores the need for meticulous neurosurgical technique in managing hydrocephalus.