TY - JOUR
T1 - Increasing chronic subdural hematoma after endoscopic III ventriculostomy
AU - Beni-Adani, Liana
AU - Siomin, Vitaly
AU - Segev, Yoram
AU - Beni, Sara
AU - Constantini, Shlomi
PY - 2000/7
Y1 - 2000/7
N2 - Object: Endoscopic III ventriculostomy (ETV) is an effective and a rather safe treatment for noncommunicating hydrocephalus secondary to aqueductal stenosis and other obstructive pathologies. Though not devoid of risk, ETV is increasingly replacing shunt operations, and it prevents related complications, including overdrainage. Methods: We report a rare case of a large chronic subdural hematoma (ChSDH) after ETV in a patient with aqueductal stenosis. Three weeks after he was shunted elsewhere, he presented to us with clinical symptoms of intracranial hypotension and overdrainage. ETV was performed and the shunt removed uneventfully. On routine postoperative MRI a few weeks later, a large ChSDH was noted, the patient being totally asymptomatic. Since the ChSDH grew significantly, causing a mass effect on the follow-up MRI, it was finally drained. Large and increasing ChSDHs have previously been reported secondary to overdrainage after shunt placement, but not after ETV. Conclusions: We conclude that though rare, a ChSDH may evolve even after ETV, if there is a substantial decrease in previously elevated intracranial pressure.
AB - Object: Endoscopic III ventriculostomy (ETV) is an effective and a rather safe treatment for noncommunicating hydrocephalus secondary to aqueductal stenosis and other obstructive pathologies. Though not devoid of risk, ETV is increasingly replacing shunt operations, and it prevents related complications, including overdrainage. Methods: We report a rare case of a large chronic subdural hematoma (ChSDH) after ETV in a patient with aqueductal stenosis. Three weeks after he was shunted elsewhere, he presented to us with clinical symptoms of intracranial hypotension and overdrainage. ETV was performed and the shunt removed uneventfully. On routine postoperative MRI a few weeks later, a large ChSDH was noted, the patient being totally asymptomatic. Since the ChSDH grew significantly, causing a mass effect on the follow-up MRI, it was finally drained. Large and increasing ChSDHs have previously been reported secondary to overdrainage after shunt placement, but not after ETV. Conclusions: We conclude that though rare, a ChSDH may evolve even after ETV, if there is a substantial decrease in previously elevated intracranial pressure.
KW - Chronic SDH
KW - Complications
KW - Endoscopic III ventriculostomy
KW - Overdrainage
KW - Shunt
UR - http://www.scopus.com/inward/record.url?scp=0033926765&partnerID=8YFLogxK
U2 - 10.1007/s003810000298
DO - 10.1007/s003810000298
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C2 - 10958548
AN - SCOPUS:0033926765
SN - 0256-7040
VL - 16
SP - 402
EP - 405
JO - Child's Nervous System
JF - Child's Nervous System
IS - 7
ER -