Usefulness of endoscopic third ventriculostomy for hydrocephalus from pineal lesion meningioma in an elderly patient: A case report

Endoscopic third ventriculostomy (ETV) is a major treatment procedure for obstructive hydrocephalus in children and adults. However, previous studies to predict the outcome of ETV, such as ETV success score, were primarily based on pediatric populations; hence, the effectiveness of ETV in elderly populations remains unclear. Here, we report the case of an 80-year-old woman with cognitive impairment and gait disturbance due to obstructive hydrocephalus caused by a pineal region meningioma. Considering that the radical resection was risky for this patient, simultaneous endoscopic tumor biopsy and ETV was performed. Based on the histopathological findings, the patient was diagnosed with meningioma. Cognition improved and gait disturbances diminished gradually 2 months after the operation. Surgical treatments for the elderly patients should not compromise activity of daily living (ADL). Our findings might help the management of elderly patients with obstructive hydrocephalus, especially in aging societies.