Intracranial migration of bone dust after intraventricular neuroendoscopy complicating acute hydrocephalus and removal of bone dust: case report
Abstract
To present the first case of neuroendoscopic removal of migrated intraventricular bone dust and gel foam after intraventricular endoscopic surgery. A 37-year-old man was admitted with a 2-year history of headache. Brain computed tomography (CT) scan and magnetic resonance imaging revealed a cavum vergae cyst. The patient was operated on by stereotactically guided endoscopic cyst fenestration with no intraoperative complications. Postoperative CT scan demonstrated regression of the cyst with no other pathological findings. Because of a postoperative fever, a lumbar puncture was performed after the brain CT scan to eliminate meningitis as a differential diagnosis. After the lumbar puncture, the patient complained of severe headache and vomiting followed by depression of consciousness. The follow-up CT scan showed the migration of bone dust from the burr hole site to the ventricular system and acute hydrocephalus. It is thought that the negative pressure gradient generated after the lumbar puncture might have been transmitted through the cerebrospinal fluid pathway, resulting in a suction effect and migration of the bone dust from the burr hole to the ventricle. An urgent reexplorative endoscopic procedure was performed, and most ...Continue Reading
References
Endoscopic third ventriculostomy in the management of obstructive hydrocephalus: an outcome analysis
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