Amenorrhea complicating endoscopic third ventriculostomy in the pediatric age group

Report of 2 cases

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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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References
  • 1

    Anandh BMadhusudan Reddy KRMohanty AUmamaheswara Rao GSChandramouli BA: Intraoperative bradycardia and postoperative hyperkalemia in patients undergoing endoscopic third ventriculostomy. Minim Invasive Neurosurg 45:1541572002

    • Search Google Scholar
    • Export Citation
  • 2

    Benabarre AIbáñez JBoget TObiols JMartínez-Aran AVieta E: Neuropsychological and psychiatric complications in endoscopic third ventriculostomy: a clinical case report. J Neurol Neurosurg Psychiatry 71:2682712001

    • Search Google Scholar
    • Export Citation
  • 3

    Bonanni RCarlesimo GACaltagirone C: Amnesia following endoscopic third ventriculostomy: a single case study. Eur Neurol 51:1181202004

    • Search Google Scholar
    • Export Citation
  • 4

    Brockmeyer DAbtin KCarey LWalker ML: Endoscopic third ventriculostomy: an outcome analysis. Pediatr Neurosurg 28:2362401998

  • 5

    Buxton NHo KJMacarthur DVloeberghs MPunt JRobertson I: Neuroendoscopic third ventriculostomy for hydrocephalus in adults: report of a single unit's experience with 63 cases. Surg Neurol 55:74782001

    • Search Google Scholar
    • Export Citation
  • 6

    Buxton NMacarthur DRobertson IPunt J: Neuroendoscopic third ventriculostomy for failed shunts. Surg Neurol 60:2012042003

  • 7

    Buxton NPunt J: Cerebral infarction after neuroendoscopic third ventriculostomy: case report. Neurosurgery 46:99910022000

  • 8

    Coenegracht JMde Bie JPCoene LNPadberg G: Deficiency of gonadotropin-releasing factor in a patient with hydrocephalus internus. Case report. J Neurosurg 43:2392431975

    • Search Google Scholar
    • Export Citation
  • 9

    Fritsch MJBauer MPartsch CJSippell WGMehdorn HM: Endocrine evaluation after endoscopic third ventriculostomy (ETV) in children. Childs Nerv Syst 23:6276312007

    • Search Google Scholar
    • Export Citation
  • 10

    Garg AKSuri ASharma BSShamim SABal CS: Changes in cerebral perfusion hormone profile and cerebrospinal fluid flow across the third ventriculostomy after endoscopic third ventriculostomy in patients with aqueductal stenosis: a prospective study. Clinical article. J Neurosurg Pediatr 3:29362009

    • Search Google Scholar
    • Export Citation
  • 11

    Goumnerova LCFrim DM: Treatment of hydrocephalus with third ventriculocisternostomy: outcome and CSF flow patterns. Pediatr Neurosurg 27:1491521997

    • Search Google Scholar
    • Export Citation
  • 12

    Hader WJWalker RLMyles STHamilton M: Complications of endoscopic third ventriculostomy in previously shunted patients. Neurosurgery 63:1 Suppl 1ONS168ONS1752008

    • Search Google Scholar
    • Export Citation
  • 13

    Handler MHAbbott RLee M: A near-fatal complication of endoscopic third ventriculostomy: case report. Neurosurgery 35:5255281994

    • Search Google Scholar
    • Export Citation
  • 14

    Hopf NJGrunert PFries GResch KDMPerneczky A: Endoscopic third ventriculostomy: outcome analysis of 100 consecutive procedures. Neurosurgery 44:7958061999

    • Search Google Scholar
    • Export Citation
  • 15

    Kim BSJallo GIKothbauer KAbbott IR: Chronic subdural hematoma as a complication of endoscopic third ventriculostomy. Surg Neurol 62:64682004

    • Search Google Scholar
    • Export Citation
  • 16

    Kim SKWang KCCho BK: Surgical outcome of pediatric hydrocephalus treated by endoscopic III ventriculostomy: prognostic factors and interpretation of postoperative neuroimaging. Childs Nerv Syst 16:1611692000

    • Search Google Scholar
    • Export Citation
  • 17

    Lowry DWLowry DLBerga SLAdelson PDRoberts MM: Secondary amenorrhea due to hydrocephalus treated with endoscopic ventriculocisternostomy. Case report. J Neurosurg 85:114811521996

    • Search Google Scholar
    • Export Citation
  • 18

    McLaughlin MRWahlig JBKaufmann AMAlbright AL: Traumatic basilar aneurysm after endoscopic third ventriculostomy: case report. Neurosurgery 41:140014041997

    • Search Google Scholar
    • Export Citation
  • 19

    Schroeder HWNiendorf WRGaab MR: Complications of endoscopic third ventriculostomy. J Neurosurg 96:103210402002

  • 20

    Teo CRahman SBoop FACherny B: Complications of endoscopic neurosurgery. Childs Nerv Syst 12:2482531996

  • 21

    Vaicys CFried A: Transient hyponatriemia complicated by seizures after endoscopic third ventriculostomy. Minim Invasive Neurosurg 43:1901912000

    • Search Google Scholar
    • Export Citation
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