Case ReportRisks of Endoscopic Temporal Ventriculocisternostomy for Isolated Lateral Ventricle: Anatomic Surgical Nuances
Introduction
Temporal horn entrapment, known as isolated lateral ventricle (ILV), is a rare type of noncommunicating focal hydrocephalus occurring as a result of surgery for brain tumors, intraventricular infections, hemorrhage, or traumatic events. Standard treatment for this condition has not been established.1 The goal of surgical treatment is to drain the ILV by connecting the temporal horn to the ventricular system or subarachnoid space or shunting to the peritoneum (ventriculoperitoneal [VP] shunt) or the atrium (ventriculoatrial shunt). The efficacy of endoscopic treatment for cerebrospinal fluid pathway obstruction, in particular, endoscopic third ventriculostomy, for obstructive hydrocephalus has been reported, and endoscopic surgeries have been used frequently to treat these conditions. With the development of endoscopic procedures, endoscopic temporal ventriculocisternostomy for ILV can also be considered to be a safe and less invasive technique.2 We report our experience with endoscopic temporal ventriculocisternostomy, including an unexpected surgical complication, along with an evaluation of this procedure. This study emphasizes the importance of vigilant anatomic attention before performing endoscopic temporal ventriculocisternostomy in patients with ILV.
Section snippets
Case Descriptions
The patients gave their consent for submission of their case reports for publication.
Discussion
There is no known established standard treatment for ILV. Based on several previous reports, surgical options for ILV are VP shunt, temporal ventriculocisternostomy (including endoscopic fenestration of the mesial temporal ventricular wall with or without stent placement), and fenestration of the choroidal fissure.1 The ILV has traditionally been treated with VP shunt placement. Although VP shunt is a safe and well-known technique, treatment of hydrocephalus with multiple septa and compartments
Conclusions
Endoscopic ventriculocisternostomy in treatment of ILV is a less invasive and effective method that leads to excellent clinical and radiographic resolution in long-term clinical outcomes. However, fenestration of the choroidal fissure includes the possibility of injury to the branches of the AChA. Adequate knowledge of the intraventricular anatomy and careful decision making regarding surgical strategy are essential to prevent surgical complications. We should recognize this risk regardless of
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Conflict of interest statement: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.