Endoscopic stereotactic surgery for intraventricular loculated empyema: Case report

BACKGROUND Ventriculitis accompanied by formation of an intraventricular loculated emp yema 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 sc ans demonstrated the development of an intraventricular loculated empyema i n the posterior portion of the left lateral ventricle. A stereotactically g uided 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 p rocedure. CONCLUSIONS Ventriculitis frequently results in severe morbidity and often causes death . Intraventricular pathologies can be treated effectively by endoscopic ste reotactic methods. To our knowledge, this is the first case of successful t reatment of an intraventricular loculated empyema in an adult. (C) 1999 by Elsevier Science Inc.