Traumatic basilar aneurysm after endoscopic third ventriculostomy: case report.
OBJECTIVE
This case illustrates that although endoscopic third ventriculostomy for patients with aqueductal stenosis is successful and minimally invasive, it can have severe, life-threatening complications.


METHODS
A 3-year-old girl presented with hydrocephalus and aqueductal stenosis. She underwent endoscopic third ventriculostomy with laser fenestration of the third ventricular floor. During the procedure, she developed a severe intraventricular hemorrhage that required prolonged external ventricular drainage and ultimately ventriculoperitoneal shunting. Despite having a negative angiogram after the procedure, she presented 1 month later with a subarachnoid hemorrhage and a traumatic basilar tip aneurysm.


METHODS
The patient underwent a right subtemporal approach with clip ligation of the aneurysm and subsequently had a good recovery.


CONCLUSIONS
Hemorrhagic complications after endoscopic third ventriculostomy are rare. The formation of a traumatic basilar tip aneurysm after this procedure has not been reported in the literature. Laser fenestration of the third ventricular floor may increase the risk of this event.
McLaughlin
M R
MR
Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pennsylvania, USA.
Wahlig
J B
JB
Kaufmann
A M
AM
Albright
A L
AL
D001488:Basilar Artery / Q000293:injuries*; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D002557:Cerebrospinal Fluid Shunts; D002675:Child, Preschool; D004322:Drainage; D004724:Endoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D002532:Intracranial Aneurysm / Q000209:etiology*; D053685:Laser Therapy / Q000009:adverse effects; D008279:Magnetic Resonance Imaging; D014057:Tomography, X-Ray Computed; D014696:Ventriculostomy / Q000009:adverse effects*