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An Idiopathic Huge Trapped Temporal Horn: Surgical Strategy and Review of Literature

Guive Sharifi, Tahereh Gahdiri, Gelareh Vakilzadeh and Davide Nasi

Background: Temporal horn entrapment is a very rare kind of isolated focal hydrocephalus, with only limited number of known cases in worldwide. To our knowledge, we present the first case of idiopathic unilateral and largest trapped temporal horn as well as a review of all similar cases published in the literature to the present time.

Case report: We present a case of 16-year-old boy with 3 months history of persistent headache, cranial asymmetry and mild stuttering. Brain imaging showed the huge trapped temporal. Considering the presence of significant midline shift, the patient underwent microscopic transtemporal ventriculocysto- cisternostomy. Post-surgery, there was a subdural hygroma, observed conservatively. Development of persistent night time headache mandates team to put subduro-peritoneal shunt which ameliorated headache completely.

Conclusion: In the presence of large entrapped temporal horn reconnection to the CSF pathway via a microsurgical ventriculo-cisternostomy could be attempted. Subdural hygroma might be a complication of this approach and can be successfully treated with a subduro-peritoneal shunt.