Intraoperative Bradycardia and Postoperative Hyperkalemia in Patients Undergoing Endoscopic Third Ventriculostomy

Eldawlatly, Abdelazeem; Takrouri, Mohamed Said; Murshid, Walid

doi:10.1055/s-2004-818473

Cited by 5 publications

(7 citation statements)

References 3 publications

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“…Attention to the volume of irrigation and its temperature as well as ICP changes during ETV and other intraventricular endoscopic procedures has been emphasized by others. [58][59][60][61][62][63] The patient who experienced status epilepticus, which occurred 1 day after ETV, sustained permanent cognitive loss and had the most serious complication in our series. The Terson syndrome developed in a 34-year-old man with a posterior third ventricle mass who had an ETV as an initial procedure but awoke with blurred vision, acuity with correction of 20/100 bilaterally, and bilateral retinal hemorrhages.…”

Section: Complicationsmentioning

confidence: 93%

Endoscopic Third Ventriculostomy in 250 Adults With Hydrocephalus

et al. 2016

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Section: Complicationsmentioning

confidence: 93%

Endoscopic Third Ventriculostomy in 250 Adults With Hydrocephalus

et al. 2016

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“…Intraoperative neural injury, such as thalamic, forniceal, hypothalamic and midbrain injuries are also observed. Intraoperative bradycardia [83] and hemorrhages including fatal hemorrhage due to basilar artery rupture are also reported. Attempts to perforate the ventricular floor can lead to bleeding, especially in hydrocephalus following an infection and hemorrhage.…”

Section: Intraoperative Complicationsmentioning

confidence: 96%

“…[87,88] Rare complications like post-operative hyperkalemia, severe parkinsonism, acute respiratory alkalosis and tachypnea can occur after endoscopic third ventriculostomy. [83,[89][90][91]…”

Section: Early Complicationsmentioning

confidence: 99%

Endoscopic third ventriculostomy

Yadav

Parihar

Pande

et al. 2012

Journal of Neurosciences in Rural Practice

103

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Endoscopic third ventriculostomy (ETV) is considered as a treatment of choice for obstructive hydrocephalus. It is indicated in hydrocephalus secondary to congenital aqueductal stenosis, posterior third ventricle tumor, cerebellar infarct, Dandy-Walker malformation, vein of Galen aneurism, syringomyelia with or without Chiari malformation type I, intraventricular hematoma, post infective, normal pressure hydrocephalus, myelomeningocele, multiloculated hydrocephalus, encephalocele, posterior fossa tumor and craniosynostosis. It is also indicated in block shunt or slit ventricle syndrome. Proper Pre-operative imaging for detailed assessment of the posterior communicating arteries distance from mid line, presence or absence of Liliequist membrane or other membranes, located in the prepontine cistern is useful. Measurement of lumbar elastance and resistance can predict patency of cranial subarachnoid space and complex hydrocephalus, which decides an ultimate outcome. Water jet dissection is an effective technique of ETV in thick floor. Ultrasonic contact probe can be useful in selected patients. Intra-operative ventriculo-stomography could help in confirming the adequacy of endoscopic procedure, thereby facilitating the need for shunt. Intraoperative observations of the patent aqueduct and prepontine cistern scarring are predictors of the risk of ETV failure. Such patients may be considered for shunt surgery. Magnetic resonance ventriculography and cine phase contrast magnetic resonance imaging are effective in assessing subarachnoid space and stoma patency after ETV. Proper case selection, post-operative care including monitoring of ICP and need for external ventricular drain, repeated lumbar puncture and CSF drainage, Ommaya reservoir in selected patients could help to increase success rate and reduce complications. Most of the complications develop in an early post-operative, but fatal complications can develop late which indicate an importance of long term follow up.

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“…Injury to the hypothalamus Improper ostomy location may lead impaired cognition, weight gain, precocious puberty [4,10]. Similarly, intraoperative bradycardia can manifest from the inadvertent injury to the posterior hypothalamus [15].…”

Section: Complications During Perforation Of the Floor Of Third Ventr...mentioning

confidence: 99%

“…Hemodynamic changes Rare reports of intraoperative asystole and hemodynamic changes have been reported. Hemodynamic changes not necessarily include bradycardia and hypertension but also tachycardia [5,15]. It is imperative to hold any surgical maneuvers such as ballooning, irrigation, endoscope manipulation when hemodynamic changes are noticed.…”

Section: Complication Due To Unbalanced Irrigation/drainagementioning

confidence: 99%

Endoscopic third ventriculostomy complications: avoidance and management in a stepwise manner

et al. 2022

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Background Various complications of endoscopic third ventriculostomy (ETV) have been described. One has to recognize these complications and learn how to avoid them. Methods We performed a literature review regarding the reported complications of ETV procedures discussed in a correlated manner with the surgical steps. Furthermore, we reviewed the technical notes described by experienced neuroendoscopists, including surgical indications, choice of the endoscopic entry point and trajectory, anatomic orientation, proper bleeding control and tight closure, to prevent and deal with such complications. Results and conclusion A lesson learned that comprehensive knowledge of ventricular anatomy with proper orientation by studying the preoperative images is mandatory and one should be aware of all complication types and rates.

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Intraoperative Bradycardia and Postoperative Hyperkalemia in Patients Undergoing Endoscopic Third Ventriculostomy

Cited by 5 publications

References 3 publications

Endoscopic Third Ventriculostomy in 250 Adults With Hydrocephalus

Endoscopic Third Ventriculostomy in 250 Adults With Hydrocephalus

Endoscopic third ventriculostomy

Endoscopic third ventriculostomy complications: avoidance and management in a stepwise manner

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