Importance of Intraoperative Monitoring of Intracranial Pressure during Endoscopic Ventriculocisternostomy

Abstract

Introduction: Neuroendoscopy is a minimally invasive neurosurgical procedure to the brain used for the treatment of an increasing number of diseases. Among its variants, endoscopic ventriculocisternostomy of the floor of the third ventricle is the treatment of choice for triventricular obstructive hydrocephalus.

Objective: To establish the importance of transoperative monitoring of intracranial pressure and other vital parameters during endoscopic ventriculocisternostomy of the floor of the third ventricle.

Clinical case report: We report the case of a 45-year-old patient with obstructive hydrocephalus secondary to a posterior fossa hemangioblastoma. He was treated by premammillary endoscopic ventriculocisternostomy of the floor of the third ventricle with monitoring of intracranial pressure and other vital parameters during the transoperative period. The procedure was carried out with no complications. The patient's symptoms improved and the necessary measurements planned during the procedure could be carried out.

Conclusions: Intraoperative monitoring of intracranial pressure reveals variations in vital parameters such as blood pressure, heart rate, and intermittent increases in intracranial pressure. This type of surgery is very useful for surgeons and anesthesiologists, since it contributes to ruling out and avoiding intraoperative complications and favorably influencing the good results of the procedure and its prognosis, as occurred in this patient.

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