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J Neurol Neurosurg Psychiatry 2002;73:460 doi:10.1136/jnnp.73.4.460
  • Correspondence

Neuropsychological and psychiatric complications in endoscopic third ventriculostomy

  1. J van Aalst1,
  2. E A M Beuls1,
  3. G J Luijckx2
  1. 1Department of Neurosurgery, University Hospital Maastricht, P Debyelaan 25, Postbus 5800, 6202 AZ Maastricht, The Netherlands
  2. 2Department of Neurology, University Hospital Groningen, Hanzeplein 1, PO Box 30001, 9700 RB Groningen, The Netherlands
  1. Correspondence to:
 Dr J van Aalst;
 jaspervanaalst{at}hotmail.com

    We read with interest the recent paper by Benabarre et al1 of the first reported case of endoscopic third ventriculostomy followed by severe psychiatric complications.

    In our department, we also had a patient who developed severe psychiatric symptoms after an endoscopic third ventriculostomy (ETV).

    A 45 year old woman with an aqueductal stenosis underwent an EVT because of progressive gait and visual disturbances. In November 1997 she underwent an ETV through a right side precoronal burr hole using a rigid neuroendoscope. The third ventricular floor was perforated with a 4 French Fogarty catheter, the perforation being enlarged with the inflatable balloon. No problems were encountered during the procedure, although we noted an incomplete septum pellucidum. After ETV her gait and visual disturbances gradually resolved. However, after the procedure the patient was nervous and agonised, and she complained of a crepitating sound in her head and behaved aggressively towards her spouse. Because her complaints and behaviour worsened a psychiatric evaluation was performed. Psychotic depression was diagnosed and three weeks after the EVT she was admitted to the department of psychiatry. For several months she was treated …

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