Neuropsychological and psychiatric complications in endoscopic third ventriculostomy: a clinical case report.

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.

• Authors: A Benabarre, J Ibáñez, T Boget, J Obiols, A Martínez-Aran, E Vieta
• Journal: Journal of neurology, neurosurgery, and psychiatry (J Neurol Neurosurg Psychiatry) Vol. 71 Issue 2 Pg. 268-71 (Aug 2001) ISSN: 0022-3050 [Print] England
• PMID: 11459910 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Brain Diseases (pathology, psychology, surgery)
• Endoscopy
• Humans
• Magnetic Resonance Imaging
• Male
• Neuropsychological Tests
• Personality Disorders (etiology, psychology)
• Syndrome
• Third Ventricle (pathology, surgery)