title: A pitfall of neuroendoscopic intraventricular hematoma removal - delayed obstructive hydrocephalus caused by a small remnant clot - case report - .
abstract: A 57-year-old female presented with a left putaminal hemorrhage, intraventricular hematoma (IVH), and acute obstructive hydrocephalus. Neuroendoscopic surgery was performed for the IVH. Three days after successful IVH removal and improvement of her consciousness, the patient lapsed into a comatose state due to hydrocephalus caused by obstruction of the mesencephalic aqueduct by a small remnant clot. The small clot was identified by constructive interference with steady state magnetic resonance imaging and was removed during a second-look operation. Even after the cerebrospinal fluid circulation improves following neuroendoscopic surgery for IVH, the patient may nevertheless develop a life-threatening condition without warning signs in the subacute phase. Awareness of this complication will lead to early diagnosis and correct management.
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan. fkomatsu@fukuoka-u.ac.jp
authors.forename: Fuminari
authors.initials: F
authors.lastname: Komatsu
authors.forename: Naoki
authors.initials: N
authors.lastname: Wakuta
authors.forename: Mika
authors.initials: M
authors.lastname: Komatsu
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Iwaasa
authors.forename: Tooru
authors.initials: T
authors.lastname: Inoue
mesh_terms: D002535:Cerebral Aqueduct / Q000473:pathology*; D002552:Cerebral Ventricles / Q000098:blood supply / Q000601:surgery*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology* / Q000628:therapy; D020300:Intracranial Hemorrhages / Q000150:complications* / Q000601:surgery; D020767:Intracranial Thrombosis / Q000150:complications* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D044583:Neuroendoscopy / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome