Transient diabetes insipidus post endoscopic third ventriculostomy: Case report and literature review

Abstract

Background: Endoscopic third ventriculostomy (ETV) is a procedure commonly used to relieve obstructive hydrocephalus. A very small percentage of patients suffers from transient or permanent hormonal disturbances following this procedure.Case Description.We report the case of a 19 years old woman with recurrent cerebellar pilocytic astrocytoma and moderate hydrocephalus. The patient underwent ETV followed by suboccipital craniotomy for resection of the lesion. Postoperatively, she suffered from polyuria and hypernatremia. Intravenous Desmopressin was given, and the patient recovered completely after few days. The patient was thought to have a transient diabetes insipidus from balloon overinflation during ETV and hypothalamic injury. Conclusion: Overinflation of the balloon during ETV and subsequent hypothalamic injury can cause DI, a rare but potentially dangerous complication of this procedure. Postoperative surveillance and management of electrolytes disturbances is crucial to prevent any long term injury. ETV must be reconsidered if the prepontine cistern is not clearly patent to avoid complications. Keywords: ETV, Diabetes insipidus, Obstructive hydrocephalus, Posterior fossa tumor