Endoscopic Third Ventriculostomy for Obstructive Hydrocephalus Secondary to Delayed Intracerebellar Hematoma

Nowadays, endoscopic third ventriculostomy (ETV) in neurosurgery has yielded good clinical results in various conditions. Intraventricular endoscopic procedures can be performed in different pathologies and not only in non-communicating hydrocephalus. This is presented accordingly in this clinical case. We present the case of a patient who suffered a blunt traumatic brain injury (TBI) in the occipital region. Upon his arrival at the medical facility, he displayed altered neurological status and showed symptoms of aggressiveness, slurred speech, and gait ataxia. Initial non-contrast brain computed tomography scan presented a cerebellar traumatic subacute hematoma and secondary hydrocephalus. Therefore, we performed an ETV. In most reported cases of cerebellar contusions among patients with TBI, the treatment was suboccipital craniectomy, clot evacuation, and external ventricular drainage (EVD). Unlike this case, the determined procedure was minimally invasive through ETV for the resolution of hydrocephalus with good clinical outcomes in addition to low morbidity and mortality. This case shows in the setting of delayed intracerebellar traumatic hematoma with secondary hydrocephalus being the main cause of neurological deterioration, a minimally invasive treatment such as ETV is suitable.