Neuropsychological and psychiatric complications in endoscopic third ventriculostomy: a clinical case report.
The clinical case report of a patient who underwent an endoscopic third ventriculostomy for the treatment of a slit ventricle syndrome is presented. After surgery the patient developed a severe complication consisting of an organic personality disorder, characterised by impulsiveness, physical heteroaggressiveness, binge eating, hypersomnia and impairment of memory, and frontal-executive functions.A frontal lobe lesion may explain some of the symptoms presented, such as the uncontrolled impulses, the aggressive behaviour, and even the binge eating. However, a longitudinal neuropsychological evaluation showed a severe deficit in immediate memory and difficulties in planning and consolidation of newly learned information, which may be best related to damage in the frontal basal structures of the brain: the fornix and its connection to the hippocampus and the mamillary bodies. Postoperative MR images confirmed the clinical hypothesis. The emergence of such a severe organic personality disorder and cognitive disturbances as a psychiatric complication of an endoscopic third ventriculostomy has not, it seems, been previously reported elsewhere. Clinicians should take these possible complications into account when recommending this so-called minimally invasive neuroendoscopic procedure.
Benabarre
A
A
Institut Clínic de Psiquiatria I Psicologia, Hospital Clínic de Barcelona, Facultat de Medicina de la Universitat de Barcelona, C/ Villarroel 170, 08036 Barcelona, Spain. 31555abh@comb.es
Ibáñez
J
J
Boget
T
T
Obiols
J
J
Martínez-Aran
A
A
Vieta
E
E
D000328:Adult; D001927:Brain Diseases / Q000473:pathology / Q000523:psychology* / Q000601:surgery*; D004724:Endoscopy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D010554:Personality Disorders / Q000209:etiology* / Q000523:psychology; D013577:Syndrome; D020542:Third Ventricle / Q000473:pathology / Q000601:surgery*