Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026
Endoscopic management of cranial screw migration to cerebral aqueduct causing hydrocephalus.
СтатьяКлинический случайПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Hect Jasmine L, Jaffee Stephen, Casillo Stephanie, Farahmand Andrew, Fitzgerald Ethan, Silliman Daniel A, Harford Emily, Piazza Martin G, Bykowski Michael, Abel Taylor J
Аннотация
BACKGROUND AND IMPORTANCE: Intracranial migration of cranial fixation hardware is a rare complication of neurosurgical procedures, and migration into the ventricular system is exceedingly uncommon. When such migration leads to obstruction of cerebrospinal fluid (CSF) pathways, it can result in acute hydrocephalus requiring urgent intervention.
CLINICAL PRESENTATION: A 10-year-old girl with a history of left frontotemporal ganglioglioma underwent synthetic Medpor cranioplasty for radiation necrosis-associated calvarial erosion. Intraoperatively, a fixation screw inadvertently plunged through a bone defect into an area of encephalomalacia. Postoperative imaging revealed the screw within the antrum of the left lateral ventricle. The patient remained asymptomatic and was discharged with close monitoring. At 3-week follow-up, she developed progressive headaches and fatigue. Neuroimaging demonstrated migration of the screw into the cerebral aqueduct, with resulting obstructive hydrocephalus. She underwent endoscopic third ventriculostomy and successful endoscopic removal of the screw, with full clinical recovery.
CONCLUSION: This case illustrates a rare but serious complication of cranioplasty: delayed migration of a cranial screw into the ventricular system causing aqueduct obstruction. Endoscopic management allowed for both CSF diversion and removal of the foreign body and was associated with an excellent clinical outcome.
CLINICAL PRESENTATION: A 10-year-old girl with a history of left frontotemporal ganglioglioma underwent synthetic Medpor cranioplasty for radiation necrosis-associated calvarial erosion. Intraoperatively, a fixation screw inadvertently plunged through a bone defect into an area of encephalomalacia. Postoperative imaging revealed the screw within the antrum of the left lateral ventricle. The patient remained asymptomatic and was discharged with close monitoring. At 3-week follow-up, she developed progressive headaches and fatigue. Neuroimaging demonstrated migration of the screw into the cerebral aqueduct, with resulting obstructive hydrocephalus. She underwent endoscopic third ventriculostomy and successful endoscopic removal of the screw, with full clinical recovery.
CONCLUSION: This case illustrates a rare but serious complication of cranioplasty: delayed migration of a cranial screw into the ventricular system causing aqueduct obstruction. Endoscopic management allowed for both CSF diversion and removal of the foreign body and was associated with an excellent clinical outcome.