Abstract
Introduction Hydrocephalus is a condition characterized by the abnormal accumulation of cerebrospinal
fluid within the brain's ventricular system. It can stem from obstructive and nonobstructive
causes. Pregnancy introduces physiopathological changes that may heighten the risk
of developing or worsening symptomatic hydrocephalus. Nevertheless, comprehensive
reports on this aspect, especially regarding surgical interventions, remain scarce.
Case Report A young woman with a history of recurrent headaches experienced a worsening of her
symptoms at the onset of her pregnancy. A magnetic resonance imaging (MRI) in the
first trimester revealed increased ventricular dilation, indicating an obstructive
cause due to aqueduct stenosis. During a neurosurgical board meeting, treatment options
were discussed, considering the identifiable obstruction, the heightened intra-abdominal
pressure associated with pregnancy, and the risk of ventricular shunt dysfunction.
The patient underwent an endoscopic third ventriculostomy (ETV) without complications,
leading to both symptom relief and a successful conclusion to the pregnancy.
Discussion Neurosurgical procedures in pregnant women are uncommon due to the increased risks
to both the mother and the fetus. However, when performed by a qualified multidisciplinary
team, they can lead to positive outcomes. In cases of hydrocephalus during pregnancy,
ETV appears to be a viable alternative for surgical intervention, particularly when
hydrocephalus becomes symptomatic and an obstructive cause is identified, whether
in patients with existing shunts or those with newly developed hydrocephalus.
Keywords
obstructive hydrocephalus - pregnancy - endoscopic third ventriculostomy - ventriculoperitoneal
shunt - case report
