Successful aqueductal plasty and stenting for tectal plate tumor after failed third ventriculostomy: a case report.
BACKGROUND
Tectal region tumors can lead to hydrocephalus secondary to aqueductal compression. Surgical options for these patients include extracranial cerebrospinal fluid (CSF) shunts, third ventriculostomy, and/or aqueductal plasty. In cases of third ventriculostomy failure, the accepted alternative is an extracranial CSF shunt. We report a patient in whom a repeat third ventriculostomy with aqueductal plasty and stenting was successful after a failed initial third ventriculostomy.


METHODS
A 12-year-old patient with hydrocephalus secondary to a tectal tumor presented with headaches and blurry vision. She had no focal neurologic findings. She underwent a third ventriculostomy. Five months after the procedure she had recurrence of her symptoms. Therefore, she underwent a secondary third ventriculostomy with aqueductal plasty and stenting. She has been symptom-free for 1 year.


CONCLUSIONS
Aqueductal plasty with stenting may be an alternative to CSF shunts in some patients with hydrocephalus because of aqueductal compression resulting from tectal tumors.
Bulsara
Ketan R
KR
Pediatric Neurosurgery Service, Division of Neurosurgery, Duke University Medical Center, Durham, NC 27705, USA.
Villavicencio
Alan T
AT
Shah
Anand J
AJ
McGirt
Matthew J
MJ
George
Timothy M
TM
D001932:Brain Neoplasms / Q000175:diagnosis / Q000601:surgery*; D002535:Cerebral Aqueduct / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D019635:Neurosurgical Procedures; D012086:Reoperation; D015607:Stents; D003336:Tectum Mesencephali; D020542:Third Ventricle / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure; D014696:Ventriculostomy