Endoscopic Removal of a Bullet That Migrated to the Third Ventricle Causing Hydrocephalus

World Neurosurg. 2017 Sep:105:1038.e11-1038.e16. doi: 10.1016/j.wneu.2017.06.078. Epub 2017 Jun 20.

Abstract

Background: Hydrocephalus caused by an intraventricular bullet is a rare event. We report a case of endoscopic removal of an intraventricular bullet.

Case description: A 66-year-old man was admitted with a gunshot wound to the head after a suicide attempt. The bullet migrated from the frontal parenchyma to the third ventricle day 4 of admission. On day 21 of admission, the patient developed hydrocephalus with obstruction of the cerebral aqueduct. The bullet was accessed through an endoscopic third ventriculostomy and removed using an endoscope.

Conclusions: Hydrocephalus may develop in patients with intraventricular foreign objects. When such objects must be removed, the endoscopic approach is a safe, efficient, and minimally invasive procedure. To our knowledge, this is the first case in the literature of foreign object removal from the ventricle via a transcortical endoscopic approach.

Keywords: Endoscopic removal; Hydrocephalus; Intraventricular bullet.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Humans
  • Hydrocephalus / diagnostic imaging
  • Hydrocephalus / etiology
  • Hydrocephalus / surgery*
  • Male
  • Neuroendoscopy / methods*
  • Third Ventricle / diagnostic imaging
  • Third Ventricle / surgery*
  • Ventriculostomy / methods*
  • Wounds, Gunshot / complications
  • Wounds, Gunshot / diagnostic imaging
  • Wounds, Gunshot / surgery*