Endoscopic third ventriculostomy in prepontine-suprasellar tuberculoma with tuberculous meningitis hydrocephalus: a case report.

Abstract

We present a case of prepontine-suprasellar tuberculoma involving the premamillary region of the third ventricular floor, a site suitable to perform an endoscopic third ventriculostomy (ETV) stoma, managed endoscopically, and discuss our findings. A 5-year-old male child was admitted in an unconscious state with a history of gradually progressive symptoms of raised intracranial pressure and low-grade fever for the last 3 months. Head computed tomography showed thick enhancing basal exudates, a prepontine-suprasellar ring-enhancing lesion with consequent obstructive hydrocephalus. The child was subjected to urgent endoscopy which revealed multiple ependymal tubercles along with prepontine-suprasellar tuberculoma involving the premamillary region of the third ventricular floor. The tuberculoma was decompressed using a 5-french catheter, and ETV was performed. Postoperatively, the child improved clinicoradiologically on antitubercular chemotherapy and needed no further cerebrospinal fluid diversion surgery; he is under regular follow-up. We conclude that ETV may be attempted even in the presence of thick basal exudates and/or prepontine-suprasellar tuberculoma.

• Authors: Deepak Jha, Prakash Khatri, Ajay Choudhary, Rajeev Sethi, Sushil Kumar
• Journal: Pediatric neurosurgery (Pediatr Neurosurg) Vol. 43 Issue 1 Pg. 42-6 ( 2007) ISSN: 1016-2291 [Print] Switzerland
• PMID: 17190988 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright (c) 2007 S. Karger AG, Basel.

Topics

• Brain Stem
• Child, Preschool
• Humans
• Hydrocephalus (microbiology)
• Male
• Neuroendoscopy
• Tuberculoma, Intracranial (complications, surgery)
• Tuberculosis, Meningeal (complications, surgery)
• Ventriculostomy (methods)