Neuropsychological and psychiatric complications in endoscopic third ventriculostomy:: a clinical case report

被引:42
作者
Benabarre, A
Ibáñez, J
Boget, T
Obiols, J
Martínez-Aran, A
Vieta, E
机构
[1] Univ Barcelona, Fac Med, Inst Clin Psiquiat Psicol 1, Hosp Clin Barcelona,Fac Med, Barcelona 08036, Spain
[2] Vall Hebron Univ Hosp, Dept Neurosurg, Barcelona, Spain
[3] SAAS, Ctr Salut Mental, Andorra, Spain
关键词
third ventriculostomy; neuropsychological complications; neuroendoscopy;
D O I
10.1136/jnnp.71.2.268
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The clinical case report of a patient who underwent an endoscopic third ventriculostomy for the treatment of a slit ventricle syndrome is presented. After surgery the patient developed a severe complication consisting of an organic personality disorder, characterised by impulsiveness, physical heteroaggressiveness, binge eating, hypersomnia and impairment of memory, and frontal-executive functions. A frontal lobe lesion may explain some of the symptoms presented, such as the uncontrolled impulses, the aggressive behaviour, and even the binge eating. However, a longitudinal neuropsychological evaluation showed a severe deficit in immediate memory and difficulties in planning and consolidation of newly learned information, which may be best related to damage in the frontal basal structures of the brain: the fornix and its connection to the hippocampus and the mamillary bodies. Postoperative MR images confirmed the clinical hypothesis. The emergence of such a severe organic personality disorder and cognitive disturbances as a psychiatric complication of an endoscopic third ventriculostomy has not, it seems, been previously reported elsewhere. Clinicians should take these possible complications into account when recommending this so-called minimally invasive neuroendoscopic procedure.
引用
收藏
页码:268 / 271
页数:4
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