Pyogenic Ventriculitis After Anterior Skull Base Surgery Treated With Endoscopic Ventricular Irrigation And Reconstruction Using a Vascularized Flap

Acta Med Okayama. 2021 Apr;75(2):243-248. doi: 10.18926/AMO/61908.

Abstract

Ventriculitis is a rare, serious complication of neurosurgery. A 59-year-old man who had undergone a craniotomy for a paranasal adenocarcinoma, developed a right frontal cystic lesion. We performed a bifrontal craniotomy to remove the lesion. The dura was repaired with non-vascularized free fascia lata in watertight fashion. Ventriculitis occurred 3 days postoperatively. Ventricular drainage, craniectomy, and endoscopic irrigation were undertaken to remove an abscess. The dura and the resection cavity were reconstructed using a vascularized anterolateral thigh adipofascial flap. His symptoms disappeared, indicating that endoscopic irrigation and reconstruction can effectively address ventriculitis even in patients in critical clinical condition.

Keywords: anterior skull base surgery; intraventricular antimicrobial therapy; surgical site infection; ventriculitis.

Publication types

  • Case Reports

MeSH terms

  • Cerebral Ventriculitis / etiology*
  • Craniotomy / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Surgical Wound Infection / etiology*
  • Therapeutic Irrigation