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A near-fatal complication of endoscopic third ventriculostomy: case report
1Department of Neurosurgery, New York University School of Medicine, New York.
Insights
A rare, life-threatening cardiac complication occurred during neuroendoscopy in a teen with hydrocephalus and an infected shunt. Prompt resuscitation led to full recovery, highlighting the need for vigilance during such procedures.
Area of Science:
- Neurosurgery
- Pediatric Neurosurgery
- Medical Device Complications
Background:
- A 14-year-old female presented with posthemorrhagic hydrocephalus and an infected ventriculopleural shunt.
- The patient underwent neuroendoscopy with the goal of complete hardware removal.
Observation:
- During the procedure, the patient experienced arrhythmia and hypertension.
- This rapidly progressed to complete cardiac arrest.
Findings:
- Successful resuscitation was achieved following the cardiac arrest.
- The patient made a complete recovery and later received a conventional shunt replacement.
Implications:
- This case reports a novel, life-threatening complication associated with neuroendoscopy.
- Neurosurgeons must be aware of and prepared for potential cardiac events during these procedures.
Abstract:
The authors treated a 14-year-old girl with posthemorrhagic hydrocephalus and an infected ventriculopleural shunt. She was taken for endoscopic third ventriculostomy with the hope of removing the hardware entirely, but she developed an arrhythmia and hypertension, followed rapidly by complete cardiac arrest. She was resuscitated successfully, made a complete recovery, and subsequently underwent a conventional shunt replacement. This is a newly reported life-threatening complication of neuroendoscopy that must be anticipated by any surgeon undertaking such a procedure.