Endoscopically guided fenestration of the choroidal fissure for treatment of trapped temporal horn

Abstract

In recent years endoscopic procedures have been used more frequently to treat loculated hydrocephalus. The trapped temporal horn, a specific type of loculation, has traditionally been treated by means of ventricular shunt placement. By opening up loculations, however, this procedure can be simplified or, in some cases, even avoided. In this report the author discusses a case of trapped temporal horn that was caused by fungal meningitis and treated using endoscopically guided fenestration of the choroidal fissure, leading to clinical and radiographic resolution of the syndrome. Using this simple procedure allows the surgeon to take advantage of normal temporal horn anatomy and landmarks, avoiding the scarred and distorted region of ventricular obstruction.

Entrapment of temporal horn: First case of bilateral occurrence and review of literature

“…To the best of our knowledge this is the first reported case with a progressive enlargement of both trapped temporal horns. Previously twelve cases of the left temporal horn and seventeen cases of the right temporal horn entrapment were reported [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20].…”

“…The entrapment is described due to choroids plexitis, intraventricular hemorrhage, intraventricular hydatid cyst, intraventricular arachnoid cyst, brain abscesses, cryptococcal meningitis, previous intraventricular surgery, neurosarcoidosis, neurocysticercosis, intra and extraventricular meningiomas, xanthogranulomas of the choroid plexus, systemic juvenile xanthogranulomatosis, gliomas and B-cell CNS lymphoma [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. In the presented case the exclusion of both temporal horns is apparently not secondary to other previous causes.…”

“…This form of focal hydrocephalus has been described in a variety of diseases including central nervous system infections, hemorrhages, trauma, extra-axial or intra-axial tumors, postoperative scarring within the trigone, neurosarcoidosis and xanthogranulomatosis [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Clinical presentation is often with headache, seizures, hemiparesis, and visual field deficits [9].…”

An Idiopathic Huge Trapped Temporal Horn: Surgical Strategy and Review of Literature

“…Etiologically, trapped temporal horn could be outcome of various brain pathologies [2,3,5,6,17,[20][21][22]. Despite description of various surgical approaches from ventriculo-cisternostomy to shunting, there is no standard surgical treatment for this rare condition.…”

Endoscopic Third Ventriculostomy through the Interfornicial Space

“…There is a report of endoscopic ventriculocisternostomy in a case of entrapped temporal horn through a choroidal fissure [5]. We report ETV in a case of congenital hydrocephalus with deficient third ventricular roof and wide interfornicial space.…”