Neuroendoscopic lavage for ventriculitis: Case report and literature review

Neurochirurgie. 2020 Apr;66(2):127-132. doi: 10.1016/j.neuchi.2019.12.005. Epub 2020 Feb 19.

Abstract

Background: Ventriculitis, one of the difficulties in neurosurgical treatment, is a significant cause of death and morbidity in patients with hydrocephalus. Neuroendoscopy is widely used in the treatment of non-communicable hydrocephalus. The advantages of neuroendoscopy may play a decisive role in the treatment of ventriculitis.

Case report and methods: We report a 34-year-old male patient with refractory fever and rapid progressive disturbance of consciousness due to ventriculitis caused by intraventricle rupture in a left colliculus abscess. He received intravenous (IV) antibiotics and saline neuroendoscopic lavage (NEL) combined with septostomy and endoscopic third ventriculostomy leading to rapid recovery and remission of symptoms. We also reviewed the use of NEL for ventriculitis in PubMed from 1970 to January 20, 2019.

Results: In our review, 93 cases (including the present report) were treated with NEL; 91 cases of infection subsided, and 7 patients died.

Conclusion: NEL may be an effective method for the treatment of ventriculitis.

Keywords: External ventricular drainage; Neuroendoscopic lavage; Neuroendoscopy; Septostomy; Ventriculitis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Brain Abscess / complications
  • Cerebral Ventriculitis / diagnostic imaging
  • Cerebral Ventriculitis / etiology
  • Cerebral Ventriculitis / surgery*
  • Endoscopy / methods*
  • Humans
  • Hydrocephalus / surgery
  • Magnetic Resonance Imaging
  • Male
  • Neurosurgical Procedures / methods*
  • Therapeutic Irrigation / methods*
  • Third Ventricle / diagnostic imaging
  • Third Ventricle / surgery
  • Treatment Outcome
  • Ventriculostomy / methods*