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Spontaneous third ventriculostomy in patients undergoing fetal surgery for myelomeningocele correction

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Abstract

Introduction

Spontaneous third ventriculostomy (STV) is characterized by the spontaneous rupture of one of the ventricle walls due to increased pressure in the third ventricle caused by obstructive hydrocephalus. Clinically, STV results in resolution of signs and symptoms of intracranial hypertension and head circumference stabilization. No spontaneous STV cases in patients with myelomeningocele have been reported in the literature. The objective of this study was to report three cases of STV in patients with type 2 Chiari malformation who underwent intrauterine treatment.

Case presentation

All patients presented clinically with increased head circumference during outpatient follow-up. Only one patient required a ventriculoperitoneal shunt implantation. The other patients did not require further intervention.

Conclusion

STV is a rare entity that is difficult to diagnose and should always be suspected in spontaneous hydrocephalus resolution, especially in early childhood. STV is not synonymous with hydrocephalus resolution.

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Authors and Affiliations

  1. Department of Neurology and Neurosurgery, Federal University of São Paulo, Sao Paulo, Brazil

    Sergio Cavalheiro, Marcos Devanir Silva da Costa, Emmanuel de Oliveira Sampaio Vasconcelos e Sá, Patricia Alessandra Dastoli & Jardel Nicácio Mendonça

  2. Latin American Fetal Medicine Foundation, Campinas, Sao Paulo, Brazil

    Renato Luis da Silveira Ximenes

  3. Department of Fetal Medicine, Santa Joana Hospital and Maternity Care, Sao Paulo, Brazil

    Stéphanno Gomes Pereira Sarmento & Antonio Fernandes Moron

  4. Department of Fetal Neurosurgery, Santa Joana Hospital and Maternity Care, Sao Paulo, Brazil

    Sergio Cavalheiro, Marcos Devanir Silva da Costa, Patricia Alessandra Dastoli & Jardel Nicácio Mendonça

Authors
  1. Sergio Cavalheiro
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  2. Marcos Devanir Silva da Costa
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  3. Emmanuel de Oliveira Sampaio Vasconcelos e Sá
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  4. Patricia Alessandra Dastoli
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  6. Renato Luis da Silveira Ximenes
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  7. Stéphanno Gomes Pereira Sarmento
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  8. Antonio Fernandes Moron
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Corresponding author

Correspondence to Marcos Devanir Silva da Costa.

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Cavalheiro, S., da Costa, M.D.S., de Oliveira Sampaio Vasconcelos e Sá, E. et al. Spontaneous third ventriculostomy in patients undergoing fetal surgery for myelomeningocele correction. Childs Nerv Syst 37, 3429–3436 (2021). https://doi.org/10.1007/s00381-021-05294-6

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  • DOI: https://doi.org/10.1007/s00381-021-05294-6

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