Ventriculostomía espontánea del tercer ventrículo simulando un quiste aracnoideo de la cisterna cuadrigeminal: reporte de caso

Alberto Ramírez Espinoza

doi:10.59594/iicqp.2025.v3n1.123

Authors

Alberto Ramírez Espinoza Sub Unidad de Atención Integral Especializada del Paciente de Neurocirugía. Instituto Nacional de Salud del Niño San Borja, Lima, Perú https://orcid.org/0000-0003-3530-5704

DOI:

https://doi.org/10.59594/iicqp.2025.v3n1.123

Keywords:

Arachnoid Cyst, Hydrocephalus, Endoscopic Third Ventriculostomy

Abstract

Background: Spontaneous third ventriculostomy (STV) occurs due to spontaneous rupture of the thinned walls of the third ventricle due to hypertensive hydrocephalus, establishing direct communication from the ventricular system to the subarachnoid space. STV may resolve or diminish the clinical picture of hydrocephalus.

Case description: We present the case of a 16-year-old female patient with persistent headache, dizziness, and vomiting. Initial neuroradiological studies showed hydrocephalus. Subsequent studies showed increased hydrocephalus with the appearance of a collection in the quadrigeminal cistern, for which an endoscopic third ventriculostomy (ETV) was indicated as surgical treatment. Symptoms improved immediately after surgery and in subsequent evaluations the patient evolved asymptomatically.

Conclusion: This case shows that ETV represents a suitable surgical approach for patients with chronic hydrocephalus and stenosis of the aqueduct of Sylvius with symptoms of progressive endocranial hypertension, with neuroradiological evolution of STV. This approach decreases the complications of the ventricular cerebrospinal fluid shunt system.

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