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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2018; 37(04): 349-351
DOI: 10.1055/s-0038-1675367
Case Report | Relato de Caso
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Migration of Oxidized Cellulose to the Ventricle as a Complication of Endoscopic Third Ventriculostomy: A Case Report

Migração da Celulose Oxidada para o ventrículo: Complicação do terceiro ventriculostomia endoscópica (TVE): Relato de caso
Aldo J. F. da Silva
1   Division of Pediatric Neurosurgery, Hospital Geral do Estado, Maceió, AL, Brazil
,
Thiago Fortes
1   Division of Pediatric Neurosurgery, Hospital Geral do Estado, Maceió, AL, Brazil
,
Rodrigo C. Bomfim
1   Division of Pediatric Neurosurgery, Hospital Geral do Estado, Maceió, AL, Brazil
,
Ângelo M. S. Bomfim Filho
1   Division of Pediatric Neurosurgery, Hospital Geral do Estado, Maceió, AL, Brazil
› Author Affiliations
Further Information

Publication History

17 February 2018

31 August 2018

Publication Date:
29 October 2018 (online)

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Abstract

Endoscopic third ventriculostomy (ETV) is an increasingly common neurosurgical procedure. Hemostatic agentes (porcine gelatin and oxidized cellulose) are normally placed to plug the cortical hole after ETV to avoid cerebral spinal fluid leakage, subdural hygroma, and hemorrhage. Here we report the case of a 6-year-old boy with hydrocephalus who underwent ETV and which oxidized cellulose was placed to plug the cortical hole. Magnetic resonance imaging of the head performed 3 months after the procedure showed the presence of oxidized cellulose in the ventricle. After an unsuccessful attempt to remove the cellulose, it was decided that the patient should be kept under observation. Two years later, the child is in good health and without any complaints. Hemostatic agents (especially oxidized cellulose) used on the cortical hole after ETV can migrate to the ventricle and compromise the procedure. Follow-up should be performed for such patients, and the main focus should be on not causing further injury.

Resumo

A Terceiro Ventriculostomia Endoscópica (TVE) é atualmente um procedimento neurocirúrgico muito utilizado. Agentes hemostáticos (gelatina suína, celulose oxidada) normalmente são colocados na pequena lobotomia após a TVE para evitar fístula liquórica, higroma subdural e sangramento. Relatamos um caso de uma criança de 6 anos com hidrocefalia que, após realizado a TVE, foi colocada celulose oxidada no local da pequena lobotomia. Depois de 6 meses, ao realizar uma RM de crânio, foi evidenciada a presença de celulose oxidada no ventrículo. Apesar da tentativa de retirada sem sucesso, foi optado por observação e após 4 anos a criança encontra-se bem, sem queixas. A utilização de agentes hemostáticos (principalmente celulose oxidada) na lobotomia após a TVE pode migrar para o ventrículo e comprometer o procedimento. Sempre com a preocupação de não causar mais danos, pode ser feito o acompanhamento do paciente.

Keywords

endoscopy - cellulose - leakage - hydrocephalus

Palavras Chave

endoscopia - celulose - fístula - hidrocefalia
 

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