| Decompression of Posterior Fossa with External Ventricular Drainage through Aqueduct of Sylvius for Massive Fourth and Third Ventricular Hemorrhage: A Case Report |
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Ho-soo Kim* , Sung-un Lee , Joon-suk Song , Ki-chang Lee |
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Department of Neurosurgery, Wallace Memorial Baptist Hospital, Busan, Korea
*Department of Neurosurgery, Busan Paik Hospital, Inje University, Busan, Korea. Moved from Wallace Memorial Baptist Hospital |
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| Abstract |
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Massive intraventricular hemorrhage (IVH) in fourth and third ventricle is regarded as fatal feature. It frequently compartmentalizes from supratentorial space. We report a case of massive IVH in fourth and third ventricle caused by hypertensive intracerebral hemorrhage (ICH) in 67 year-old male. Early decompression of posterior fossa with evacuation of fourth and third ventricle hematoma resulted in improved mental status. Suboccipital craniectomy was performed to decompress and remove the fourth ventricle hematoma directly. However, the third ventricle and aqueductal patency was not established. Therefore, we inserted a silastic catheter through the aqueduct to the third ventricle. Decompression of posterior fossa and direct removal of hematoma in fourth and third ventricle is recommended as soon as possible. Intraoperative insertion of a silastic catheter through the aqueduct of Sylvius might be a method to remove the third ventricular hemorrhage immediately. |
| Key Words:
Intraventricular hemorrhageㆍFourth ventricleㆍThird ventricleㆍAqueduct of Sylviusㆍ External ventricular drainage (EVD) |
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