Entrapped temporal horn syndrome: a retrospective analysis of 5 case series

Abstract

Introduction: Entrapped temporal horn (ETH) syndrome is a rare form of localized noncommunicating hydrocephalus, which is often associated with the treatment of lesions around the trigone area (atrium) of the lateral ventricles. So far, only a few cases have been reported in the literature. Thus, we present our experience with the causes and management of patients with ETH syndrome at our institution. Materials and method: We retrospectively analyzed clinical data of 5 patients with ETH syndrome treated at our facility from July 2018 to August 2021. Patients’ data such as age, sex, initial disease, clinical presentation, radiologic diagnosis, treatment, and outcomes were documented and analyzed. Results: Our patients comprise of 3 females and 2 males. Their ages ranged from 42 to 85 years, with a mean age of 62 years. Postoperative adhesions caused ETH in 3 patients while meningioma and intracranial infection cause the ETH in 2 patients, respectively. One patient was treated via craniotomy, 3 patients were treated via shunting while 1 patient was treated conservatively. The ETH resolved in 4 patients, while no resolution was attained in 1 patient. Conclusion: Definitive treatments via craniotomy or shunting were capable of resolving the ETHs, while conservative treatment did not result in spontaneous resolution. Unresected meningioma around the trigone of the lateral ventricle is capable of causing the ETH, contrary to the notion that, infection or postoperative adhesions are the key causes of ETH. Thus, neurosurgeons ought to be on a lookout for ETH when treating lesions around the trigone area of the lateral ventricles.

Entrapment Syndrome in a Kidney Transplant Recipient with Cryptococcal Meningitis

“…Infectious causes of a trapped temporal horn, such as meningitis, ventriculitis, and hydatid cysts, as well as intraventricular neurocysticercosis and the development of fibrosis, are thought to be predisposing factors [ 8 , 9 , 10 ]. Meningitis and ventriculitis are thought to damage the ventricular wall ependyma, causing glial tissue tuft growth and subsequent septation, which can continue to enlarge and advance even with control of the underlying meningitis [ 9 , 10 , 11 ]. Clinical manifestations include headache, visual field defects, and even seizures and hemiparesis [ 10 ].…”

“…Meningitis and ventriculitis are thought to damage the ventricular wall ependyma, causing glial tissue tuft growth and subsequent septation, which can continue to enlarge and advance even with control of the underlying meningitis [ 9 , 10 , 11 ]. Clinical manifestations include headache, visual field defects, and even seizures and hemiparesis [ 10 ].…”

“…Because the choroid plexus is the interface between the CSF and systemic circulation, it is the portal of entry for many pathogens, including cytomegalovirus, tuberculosis, and other infectious agents, in addition to Cryptococcus spp. Zhuang et al previously described a case of presumed bacterial meningitis complicated by an entrapped temporal horn two months after successful antimicrobial treatment [ 10 ]. Another case described a young woman with central nervous system tuberculosis which led to a trapped right temporal horn and focal hydrocephalus [ 14 ].…”

Trapped temporal horn: From theory to practice, a systematic review of current understanding and future perspectives

“…Computed tomography (CT) and magnetic resonance imaging (MRI) are imaging techniques used to identify ETH. 4 The insertion of a ventriculoperitoneal shunt (VPS) has been the standard treatment for successful decompression of TTH. High revision rates in the long-term follow-up are a result of postoperative complications such as mechanical obstruction and infection, which are still frequent despite advancements in surgical techniques and implants that have increased shunt durability.…”