Endoscopic stereotactic surgery for intraventricular loculated empyema: Case report

BACKGROUND Ventriculitis accompanied by formation of an intraventricular loculated empyema is a very unusual complication of purulent meningitis. CASE DESCRIPTION A 62-year-old man presented with acute purulent ventriculitis secondary to a small paraventricular abscess. The well-documented computed tomography scans demonstrated the development of an intraventricular loculated empyema in the posterior portion of the left lateral ventricle. A stereotactically guided endoscopic procedure was performed to drain and rinse the empyema and to remove membranous tissue in order to establish free communication with the ventricular system. In the further course, a ventriculoperitoneal shunt was placed. The patient had recovered almost completely 1 year after the procedure. CONCLUSIONS Ventriculitis frequently results in severe morbidity and often causes death. Intraventricular pathologies can be treated effectively by endoscopic stereotactic methods. To our knowledge, this is the first case of successful treatment of an intraventricular loculated empyema in an adult. (C) 1999 by Elsevier Science Inc.