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J Neurol Neurosurg Psychiatry 2001;71:268-271 ( August )

Short report

Neuropsychological and psychiatric complications in endoscopic third ventriculostomy: a clinical case report A Benabarrea, J Ibáñezb, T Bogeta, J Obiolsa c, A Martínez-Arana, E Vietaa

a Institut Clínic de Psiquiatria I Psicologia. Hospital Clínic de Barcelona, Facultat de Medicina de la Universitat de Barcelona, C/ Villarroel 170; 08036 Barcelona, Spain, b Department of Neurosurgery. Vall d'Hebron University Hospitals. Barcelona, Spain, c Centred salut mental, SAAS, Andorra, Spain

Correspondence to: Dr A Benabarre 31555abh{at}comb.es

Received 29 December 1999 and in revised form 27 October 2000; Accepted 7 February 2001

The clinical case report of a patient who underwent an endoscopic third ventriculostomy for the treatment of a slit ventricle syndrome is presented. After surgery the patient developed a severe complication consisting of an organic personality disorder, characterised by impulsiveness, physical heteroaggressiveness, binge eating, hypersomnia and impairment of memory, and frontal-executive functions.
A frontal lobe lesion may explain some of the symptoms presented, such as the uncontrolled impulses, the aggressive behaviour, and even the binge eating. However, a longitudinal neuropsychological evaluation showed a severe deficit in immediate memory and difficulties in planning and consolidation of newly learned information, which may be best related to damage in the frontal basal structures of the brain: the fornix and its connection to the hippocampus and the mamillary bodies. Postoperative MR images confirmed the clinical hypothesis. The emergence of such a severe organic personality disorder and cognitive disturbances as a psychiatric complication of an endoscopic third ventriculostomy has not, it seems, been previously reported elsewhere. Clinicians should take these possible complications into account when recommending this so-called minimally invasive neuroendoscopic procedure.


Keywords: third ventriculostomy; neuropsychological complications; neuroendoscopy


© 2001 by Journal of Neurology, Neurosurgery, and Psychiatry



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J. Neurol. Neurosurg. PsychiatryHome page
J van Aalst, E A M Beuls, G J Luijckx, A Benabarre, T Boget, E Vieta, and A Martinez-Aran
Neuropsychological and psychiatric complications in endoscopic third ventriculostomy
J. Neurol. Neurosurg. Psychiatry, October 1, 2002; 73(4): 460 - 460.
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