{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T17:15:51Z","timestamp":1788628551247,"version":"build-2803163510"},"reference-count":25,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>The placement of external ventricular drainage (EVD) to treat hydrocephalus secondary to a cerebellar stroke is controversial because it has been associated to upward transtentorial herniation (UTH). This case illustrates the effectiveness of endoscopic third ventriculostomy (ETV) after the ascending herniation has occurred.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Case Description: <\/jats:title>\n<jats:p>A 50-year-old man had a cerebellar stroke with hemorrhagic transformation, tonsillar herniation, and non-communicating obstructive hydrocephalus. Considering that the patient was anticoagulated and thrombocytopenic, an EVD was placed initially, followed by clinical deterioration and UTH. We performed a suboccipital craniectomy immediately after clinical worsening, but the patient did not show clinical or radiological improvement. On the 5<jats:sup>th<\/jats:sup> day, we did an ETV, which reverses the upward herniation and hydrocephalus. The patient improved progressively with good neurological recovery.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>ETV is an effective and safe procedure for obstructive hydrocephalus. The successful resolution of the patient\u2019s upward herniation after the ETV offers a potential option to treat UTH and advocates further research in this area.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_140_2021","type":"journal-article","created":{"date-parts":[[2021,7,6]],"date-time":"2021-07-06T13:29:47Z","timestamp":1625578187000},"page":"334","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Upward transtentorial herniation: A new role for endoscopic third ventriculostomy"],"prefix":"10.25259","volume":"12","author":[{"given":"J\u00falia","family":"Moscardini-Martelli","sequence":"first","affiliation":[{"name":"Department of Medicine, Faculty of Health Sciences, Universidad An\u00e1huac,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Antonio","family":"Ponce-Gomez","sequence":"additional","affiliation":[{"name":"Neurological Center, Centro M\u00e9dico ABC,"},{"name":"Department of Neurological Surgery, Hospital \u00c1ngeles Pedregal,"},{"name":"Department of Neurological Surgery, Instituto Nacional de Neurolog\u00eda y Neurocirug\u00eda \u201cManuel Velasco Su\u00e1rez\u201d,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Alcocer-Barradas","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Hospital \u00c1ngeles Pedregal,"},{"name":"Department of Neurological Surgery, Instituto Nacional de Neurolog\u00eda y Neurocirug\u00eda \u201cManuel Velasco Su\u00e1rez\u201d,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Romano-Feinholz","sequence":"additional","affiliation":[{"name":"Neurological Center, Centro M\u00e9dico ABC,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Padilla-Quiroz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Fundaci\u00f3n Cl\u00ednica M\u00e9dica Sur."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcela Osuna","family":"Zazueta","sequence":"additional","affiliation":[{"name":"Neurological Center, Centro M\u00e9dico ABC,"},{"name":"Department of Neurological Surgery, Hospital \u00c1ngeles Pedregal,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Alberto","family":"Ortega-Porcayo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Health Sciences, Universidad An\u00e1huac,"},{"name":"Neurological Center, Centro M\u00e9dico ABC,"},{"name":"Department of Neurological Surgery, Hospital \u00c1ngeles Pedregal,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2021,7,6]]},"reference":[{"key":"10.25259\/SNI_140_2021\/ref-1","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1097\/01.nrl.0000159982.63592.9f","article-title":"Upward transtentorial herniation, hydrocephalus, and cerebellar edema in hypertensive encephalopathy","volume":"11","author":"Adamson","year":"2005","journal-title":"Neurologist"},{"key":"10.25259\/SNI_140_2021\/ref-2","doi-asserted-by":"crossref","first-page":"E1","DOI":"10.3171\/2012.2.FOCUS11369","article-title":"Controversies in the neurosurgical management of cerebellar hemorrhage and infarction","volume":"32","author":"Amar","year":"2012","journal-title":"Neurosurg Focus"},{"key":"10.25259\/SNI_140_2021\/ref-3","doi-asserted-by":"crossref","first-page":"762","DOI":"10.3171\/jns.2004.101.5.0762","article-title":"Continuous-flow shunt for treatment of hydrocephalus due to lesions of the posterior fossa","volume":"101","author":"Arriada","year":"2004","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_140_2021\/ref-4","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1007\/BF01407448","article-title":"Indications for surgical treatment of cerebellar haemorrhage and infarction","volume":"79","author":"Auer","year":"1986","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_140_2021\/ref-5","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1007\/s12028-017-0487-3","article-title":"Ventriculostomy and risk of upward herniation in patients with obstructive hydrocephalus from posterior fossa mass lesions","volume":"28","author":"Braksick","year":"2018","journal-title":"Neurocrit Care"},{"key":"10.25259\/SNI_140_2021\/ref-6","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1001\/archneur.1979.00500460052006","article-title":"Upward transtentorial herniation: Seven cases and a literature review","volume":"36","author":"Cuneo","year":"1979","journal-title":"Arch Neurol"},{"key":"10.25259\/SNI_140_2021\/ref-7","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1001\/archneur.1964.00460140086011","article-title":"Spontaneous hemorrhage in the posterior fossa. 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