Neuropsychological and psychiatric complications in endoscopic third ventriculostomy: a clinical case report. Issue 2 (1st August 2001)

• Record Type: Journal Article
• Authors: Benabarre, A; Ibáñez, J; Boget, T; Obiols, J; Martínez-Aran, A; Vieta, E
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 71:Issue 2(2001)
• Page Start: 268
• Page End: 271
• Publication Date: 2001-08-01
• Subjects: third ventriculostomy -- neuropsychological complications -- neuroendoscopy; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp.71.2.268
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : The clinical case report of a patient who underwent an endoscopic third ventriculostomy for the treatment of a slit ventricle syndrome is presented. After surgery the patient developed a severe complication consisting of an organic personality disorder, characterised by impulsiveness, physical heteroaggressiveness, binge eating, hypersomnia and impairment of memory, and frontal-executive functions. A frontal lobe lesion may explain some of the symptoms presented, such as the uncontrolled impulses, the aggressive behaviour, and even the binge eating. However, a longitudinal neuropsychological evaluation showed a severe deficit in immediate memory and difficulties in planning and consolidation of newly learned information, which may be best related to damage in the frontal basal structures of the brain: the fornix and its connection to the hippocampus and the mamillary bodies. Postoperative MR images confirmed the clinical hypothesis. The emergence of such a severe organic personality disorder and cognitive disturbances as a psychiatric complication of an endoscopic third ventriculostomy has not, it seems, been previously reported elsewhere. Clinicians should take these possible complications into account when recommending this so-called minimally invasive neuroendoscopic procedure.