Sgaramella E, Sotgiu S, Crotti F M
Department of Neurosurgery, Sassari University School of Medicine, Viale Dante 1b, 07100 Sassari, Italy.
Minim Invasive Neurosurg. 2003 Dec;46(6):354-6. doi: 10.1055/s-2003-812502.
Endoscopic third ventriculostomy is considered a safe technique for the treatment of obstructive hydrocephalus. However, the literature contains several reports of complications related to this procedure. We describe a case of chronic subdural hematoma (CSDH) after ETV, which required surgical evacuation, in a 69-year-old male patient completely asymptomatic up to the control MRI four weeks after the operation. We believe this unusual complication could result from the ICP changes caused by ETV. In our opinion, successful ETV gives a boost to CSF absorption, and overdrainage may evolve also in endoscopic treatment of obstructive hydrocephalus. This situation could be the starting point of the subdural collection. We review the literature and discuss the causes that may lead to CSDH after ETV procedure.
内镜下第三脑室造瘘术被认为是治疗梗阻性脑积水的一种安全技术。然而，文献中有几篇关于该手术相关并发症的报道。我们描述了一例内镜下第三脑室造瘘术后发生慢性硬膜下血肿（CSDH）的病例，该患者为69岁男性，术后四周直至对照MRI检查时一直完全无症状，该慢性硬膜下血肿需要手术清除。我们认为这种不寻常的并发症可能是由内镜下第三脑室造瘘术引起的颅内压变化导致的。我们认为，成功的内镜下第三脑室造瘘术可促进脑脊液吸收，在梗阻性脑积水的内镜治疗中也可能出现过度引流的情况。这种情况可能是硬膜下积液的起始点。我们回顾了文献并讨论了内镜下第三脑室造瘘术后可能导致慢性硬膜下血肿的原因。
