Tekin Tamer, Colak Ahmet, Kutlay Murat, Demircan Mehmet Nusret
Van Military Hospital, Department of Neurosurgery, Van, Turkey.
Turk Neurosurg. 2012;22(1):119-22. doi: 10.5137/1019-5149.JTN.3336-10.0.
Chronic subdural hematoma is a very rarely observed complication after endoscopic third ventriculostomy (ETV). A 21-year-old male patient was admitted to our clinic with complaining of headache, weakness and tremor. The fundoscopic examination revealed slightly indistinct border of the papilla and neurological examination findings were normal. The cranial computed tomographic (CT) and magnetic resonance imaging (MRI) findings demonstrated three-ventricular hydrocephalus due to aqueductal stenosis and ETV was performed. The symptoms got better after the operation. At 1½ month postoperatively the patient reapplied to our clinic with a symptom of severe headache. Cranial BT imaging demonstrated enlargement of subdural hematoma. The hematoma was treated by burr-hole evacuation and drainage and totally disappeared in the postoperative period. The follow-up CT scan was evaluated as normal. Nowadays, ETV is accepted as a safe and an alternative method for the treatment of obstructive hydrocephalus instead of shunt operation. Chronic subdural hematoma is a rarely observed complication after ETV.
慢性硬膜下血肿是内镜下第三脑室造瘘术(ETV)后一种非常罕见的并发症。一名21岁男性患者因头痛、乏力和震颤前来我院就诊。眼底检查显示视乳头边界稍模糊,神经系统检查结果正常。头颅计算机断层扫描(CT)和磁共振成像(MRI)结果显示因导水管狭窄导致三脑室脑积水,遂行ETV手术。术后症状好转。术后1个半月,患者因严重头痛症状再次来我院就诊。头颅CT成像显示硬膜下血肿增大。通过钻孔引流治疗血肿,术后血肿完全消失。随访CT扫描评估为正常。如今,ETV被认为是一种安全的、可替代分流手术治疗梗阻性脑积水的方法。慢性硬膜下血肿是ETV后一种罕见的并发症。