Chronic subdural hematoma as a complication of endoscopic third ventriculostomy.
BACKGROUND
Endoscopic third ventriculostomy has become a popular alternative to ventricular shunts for noncommunicating hydrocephalus. Although endoscopic third ventriculostomy is a safe procedure, several complications related to this procedure have been reported in the literature. The authors present a rare case of symptomatic bilateral subdural hematomas after an uneventful endoscopic third ventriculostomy.


METHODS
A 51-year-old male patient presented with symptoms of obstructive hydrocephalus, headaches and memory disturbance. Magnetic resonance imaging demonstrated hydrocephalus secondary to aqueductal stenosis. An endoscopic third ventriculostomy was performed. The patient was discharged home in several days without complication. He then presented with headaches 3 weeks following surgery. A computed tomography study demonstrated bilateral subdural hematomas. These were treated with burr hole evacuation and drainage. Postoperatively, his headaches improved. At last follow-up he remains symptom-free and has radiographic evidence of a patent ventriculostomy.


CONCLUSIONS
This case confirms chronic subdural hematoma formation is a possible complication following third ventriculostomy. Patients should be followed closely for possible subdural hematoma formation.
Kim
Bong-Soo
BS
Division of Pediatric Neurosurgery, Institute for Neurology and Neurosurgery, Beth Israel Medical Center, New York, New York, USA.
Jallo
George I
GI
Kothbauer
Karl
K
Abbott
I Rick
IR
D020200:Hematoma, Subdural, Chronic / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy / Q000009:adverse effects*; D020542:Third Ventricle / Q000601:surgery*; D014696:Ventriculostomy / Q000009:adverse effects*