Journal of Neurosurgical Sciences 2020 Dec 09

DOI: 10.23736/S0390-5616.20.05111-5

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Entrapment of the temporal horn: case series and systematic review of literature

Marco GIUGLIANO ¹, Anthony K. SCAFA ¹ ✉, Vito CHIARELLA ¹, Alessandro DI BARTOLOMEO ¹, Placido BRUZZANITI ¹, Giancarlo D’ANDREA ², Maurizio SALVATI ¹, Antonio SANTORO ¹

¹ Department of Neurological Sciences, Neurosurgery, La Sapienza University of Rome, Rome, Italy; ² Department of Neurosurgery, Fabrizio Spaziani Hospital, Frosinone, Italy

Entrapment of the temporal horn (ETH) is a form of focal, obstructive hydrocephalus. Etiology and clinical presentation are diversified. Though known since 1947, standard treatment has not yet been defined. The objective of our study was to perform a systematic review on ETH. Data from patients treated at our Institution from 2008 to 2019 were retrospectively collected and analyzed. A systematic PRISMA review of literature was also performed using PubMed and Google Scholar. 121 cases (mean age 41 years; M/F ratio 1/1) were analyzed. In 65 (vs 56) cases (53.7% vs 46.3%) ETH was not surgery related. Headache was the most common symptom (42%). “Major” treatments were (1) ventriculoperitoneal/ventriculoatrial shunt (42 cases, 34.7%), and (2) endoscopic ventriculocisternostomy (12 cases, 9.9%). In the first group, no perioperative complications were found, 39 patients (92.9%) had a favorable outcome, 3 patients (7.1%) died for the underlying disease, 4 cases (9.5%) went through revision; also considering the cases in which another procedure was performed as definitive treatment, shunt failures were 6 (13.6%). In the second group, 1 case (8.3%) developed a deep intracerebral hemorrhage, 11 cases (91.6%) had a favorable long-term outcome, 1 case (8.3%) had a favorable short-term outcome; also considering the cases in which another procedure was performed as definitive treatment, endoscopic ventriculocisternostomy failures were 6 (37.5%). Described as uncommon, ETH is probably underestimated. Early diagnosis and appropriate treatment are critical. VP shunt is still the most commonly performed treatment. Further randomized clinical trials are, however, needed to establish the gold standard.

KEY WORDS: Endoscopic ventriculocisternostomy; Hydrocephalus; Temporal horn entrapment; Ventriculoperitoneal shunt