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CC BY-NC-ND 4.0 · J Neurol Surg Rep 2024; 85(02): e59-e65
DOI: 10.1055/s-0044-1786822
Case Report

Endoscopic Third Ventriculostomy for the Management of Obstructive Hydrocephalus in Pregnancy: A Case Report and Review of the Literature

Alejandro Durán-Ojeda 
1   Neurosurgery Research Group, NeuroAxis SAS, Bogotá, Colombia
2   Department of Clinical Epidemiology, Universidad de los Andes, Bogotá, Colombia
,
Santiago Campos-Fajardo 
1   Neurosurgery Research Group, NeuroAxis SAS, Bogotá, Colombia
,
Silvia Suárez-Monsalve
1   Neurosurgery Research Group, NeuroAxis SAS, Bogotá, Colombia
3   Department of Clinical Epidemiology, Pontificia Universidad Javeriana, Bogotá, Colombia
,
Carlos Alberto Lindado-Pacheco
1   Neurosurgery Research Group, NeuroAxis SAS, Bogotá, Colombia
4   Department of Neurosurgery, Pontificia Universidad Javeriana, Bogotá, Colombia
,
Jaime Eduardo Becerra-Ospina
1   Neurosurgery Research Group, NeuroAxis SAS, Bogotá, Colombia
4   Department of Neurosurgery, Pontificia Universidad Javeriana, Bogotá, Colombia
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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

Ethical Considerations

We addressed ethical considerations in the publication of this case report in adherence to the Declaration of Helsinki. Patient confidentiality is preserved, and the patient fully understands the nature, benefits, and risks of the research, as well as the academic interest in publishing her medical history. Any potentially identifying information has been omitted or altered. Informed consent was obtained from the patient.




Publication History

Received: 19 March 2024

Accepted: 06 April 2024

Article published online:
13 May 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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