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Child's Nervous System

, Volume 34, Issue 8, pp 1593–1597 | Cite as

Endoscopic ventriculo-cisterno-ventricular approach in the treatment of bilateral trapped temporal horn related to fungal infection in a child: case report and review of the literature

  • José Ascención Arenas-Ruiz
  • Horus Martinez-Maldonado
  • Vicente Gonzalez-Carranza
  • Samuel Torres-García
  • Fernando Chico-Ponce de Leon
Case Report
  • 32 Downloads

Abstract

Introduction

Focal hydrocephalus including trapped temporal horn (TTH), isolated lateral and fourth ventricles, is caused by obstruction and/or adhesion related to various etiologies. With the advent of the neuroendoscope, endoscopic procedures have become an alternative in selected cases.

Case report

A 2-year-old male from a rural town in México was referred to our institution because of multiple supra- and infra-tentorial abscesses and hydrocephalus. The patient had progressive deterioration and developed bilateral trapped temporal horn related to multi-septated hydrocephalus, so we performed an endoscopic ventricular-cistern-ventriculostomy through a single right temporal burr hole.

Postoperative course

Bilateral TTH and multi-septated hydrocephalus were effectively treated with a single external ventricular drainage (EVD) catheter, from the right temporal horn to the left temporal horn through the interpeduncular cistern; after clamping the EVD for 3 days with no evidence of hydrocephalus, the EVD was removed. The size of the ventricles remained stable afterwards, and no clinical or radiological evidence of hydrocephalus was observed after 3 months of follow-up.

Discussion

Endoscopic ventriculocisternostomy is effective in selected cases of TTH. We know that dilatation of the temporal horn widens the window between the anterior choroidal artery and optic tract superiorly, and the posterior communicating and CN III inferiorly, making the described procedure feasible, even in the approach to the contralateral side. Even though this is a rare condition, we believe it is a safe and effective option to eliminate multiple shunts and/or to reduce the number of catheters needed to treat bilateral THH related to multi-septated hydrocephalus.

Keywords

Multi-septated hydrocephalus Trapped temporal horn Ventriculocisternostomy Neuroendoscopy 

Notes

Compliance with ethical standards

Conflict of interest

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • José Ascención Arenas-Ruiz
    • 1
  • Horus Martinez-Maldonado
    • 1
  • Vicente Gonzalez-Carranza
    • 1
  • Samuel Torres-García
    • 1
  • Fernando Chico-Ponce de Leon
    • 1
  1. 1.Hospital Infantil de México Federico GómezNational Institute of HealthCiudad de MéxicoMexico

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