Death after late failure of third ventriculostomy in children

Update item information
Publication Type Journal Article
School or College School of Medicine
Department Neurosurgery
Creator Kestle, John R. W.
Other Author Hader, Walter J.; Drake, James; Cochrane, Douglas; Sparrow, Owen; Johnson, Edward S.
Title Death after late failure of third ventriculostomy in children
Date 2002
Description Late failure following successful third ventriculostomy for obstructive hydrocephalus is rare, and death caused by failure of a previously successful third ventriculostomy has been reported only once. The authors present three patients who died as a result of increased intracranial pressure (ICP) after late failure of a third ventriculostomy. Through a collaborative effort, three patients were identified who had died following third ventriculostomy at one of the authors' institutions. A 13-year-old girl with neurofibromatosis Type 1 underwent third ventriculostomy for obstructive hydrocephalus caused by a tectal lesion. Three years later her condition deteriorated rapidly over the course of 6 hours and she was found dead at home. A 4-year-old boy treated with third ventriculostomy for aqueductal stenosis presented 2 years postoperatively with symptoms of increased ICP. This patient suffered a cardiorespiratory arrest while under observation and died despite external ventricular drainage. A 10-year-old boy with previous ventriculoperitoneal (VP) shunt placement underwent conversion to a third ventriculostomy and shunt removal. Eight months after the procedure his condition deteriorated, with evidence of raised ICP, and he underwent emergency insertion of another VP shunt, but remained in a vegetative state and died of complications. Neuropathological examinations in two cases demonstrated that the third ventriculostomy was not patent, and there was also evidence of increased ICP. Late failure of third ventriculostomy resulting in death is a rare complication. Delay in recognition of recurrent ICP symptoms and a false feeling of security on the part of family and caregivers because of the absence of a shunt and the belief that the hydrocephalus has been cured may contribute to fatal complications after third ventriculostomy. Patients with third ventriculostomies should be followed in a manner similar to patients with cerebrospinal fluid shunts.
Type Text
Publisher American Association of Neurological Surgeons (AANS)
Volume 97
Issue 1
First Page 211
Last Page 215
Subject Ventriculostomy; Obstructive hydrocephalus; Late failure; Death
Subject LCSH Hydrocephalus in children; Hydrocephalus in children -- Complications
Language eng
Bibliographic Citation Hader, W. J., Drake, J., Cochrane, D., Sparrow, O., Johnson, E. S., & Kestle, J. R. W. (2002). Death after late failure of third ventriculostomy in children. Report of three cases. Journal of Neurosurgery, 97(1), 211-5.
Rights Management (c) American Association of Neurological Surgeons
Format Medium application/pdf
Format Extent 214,782 bytes
Identifier ir-main,13186
ARK ark:/87278/s66m3r52
Setname ir_uspace
Date Created 2012-06-13
Date Modified 2012-06-13
ID 704730
Reference URL