Amenorrhea complicating endoscopic third ventriculostomy in the pediatric age group

Report of 2 cases

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  • Division of Pediatric Neurosurgery, Texas Children's Hospital, Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
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Endoscopic third ventriculostomy (ETV) is an accepted option in the treatment of obstructive hydrocephalus in children and is considered by many pediatric neurosurgeons to be the treatment of choice in this population. The procedure involves perforation of the floor of the third ventricle, specifically, the tuber cinereum, which is part of the hypothalamic-pituitary axis of cerebral endocrine regulation. Endocrine dysfunction, such as amenorrhea, weight gain, and precocious puberty, which are recognized only months to years after the procedure, may be underreported because patients and physicians may not relate the endocrine sequelae to the ETV. Few detailed reports of endocrinerelated complications following ETV exist to better understand these issues. In this study, the authors add to the literature with case descriptions of and correlative laboratory findings in 2 adolescent girls who underwent ETV for obstructive hydrocephalus and in whom amenorrhea subsequently developed.

Abbreviations used in this paper: ETV = endoscopic third ventriculostomy; FSH = follicle-stimulating hormone; GnRH = gonadotropin-releasing hormone; IGF-I = insulin-like growth factor–I; LH = luteinizing hormone; TSH = thyroid-stimulating hormone.

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Contributor Notes

Address correspondence to: Andrew Jea, M.D., Texas Children's Hospital, 6621 Fannin Street, CCC 1230.01, 12th Floor, Houston, Texas 77030. email: ajea@bcm.tmc.edu.
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