Stereotactic and endoscopic treatment of the trapped temporal horn

Abstract Background Current treatment of a trapped temporal horn consists primarily of ventriculo-peritoneal (VP) shunting. Objective As a less invasive alternative, we examined an endoscopic-stereotactic approach to connect the trapped temporal horn with the prepontine cistern. Methods Six patients with different etiology of entrapment were studied. Using frame-based stereotaxy, image fusion and endoscopy a Rickham catheter was placed connecting both compartments. Results After median follow-up of 22.1 ± 7.8 months all patients improved symptomatically and the size of the temporal horn was normalized. No morbidity was encountered. Conclusion Endoscopic-stereotactic internal shunting of trapped temporal horns into the prepontine cistern can be done with favorable risk profile, and it offers an elegant alternative to traditional VP shunting, by avoiding the inherent complications.