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  • Arrested hydrocephalus treated with third ventriculostomy

    Final Number:

    Jennifer Hong MD; David F. Bauer MD; Benjamin Barrena B.A.; Stuart Scott Lollis MD

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2014 Annual Meeting

    Introduction: Arrested hydrocephalus is defined as stable ventriculomegaly without evidence of neurologic deterioration or symptoms. Management of arrested hydrocephalus in asymptomatic adults is controversial with little clinical data. This case report highlights the potential for decompensation in adults with arrested hydrocephalus and reviews the literature to date regarding pathophysiology and management of this clinical entity.

    Methods: Case report.

    Results: A 39 year-old gentleman with arrested hydrocephalus incidentally found during work-up for new-onset seizure and managed conservatively for ten years presented with increasing headache, memory loss, gait instability and urinary incontinence. Stable massive triventriculomegaly was documented on serial brain imaging, and ophthalmologic exam was negative for papilledema. The patient underwent endoscopic third ventriculostomy with post-operative improvement of headache and cognitive symptoms.

    Conclusions: Early recognition of arrested hydrocephalus and its potential for decompensation may prompt more aggressive surgical treatment and prevent neurologic deterioration.

    Patient Care: This case report and literature review will alert the wider neurosurgery community, including non-pediatric neurosurgeons about the potential for decompensation in arrested hydrocephalus, and the evidence for early intervention.

    Learning Objectives: By the conclusion of this session participants should be able to 1. Define arrested hydrocephalus 2. Understand the presentation of decompensated arrested hydrocephalus 3. Understand the treatment options for arrested hydrocephalus


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