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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This article has been cited by other articles:
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van Aalst, J, Beuls, E A M, Luijckx, G J, Benabarre, A, Boget, T, Vieta, E, Martinez-Aran, A
(2002). Neuropsychological and psychiatric complications in endoscopic third ventriculostomy. J. Neurol. Neurosurg. Psychiatry
73: 460-460
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