--- a
+++ b/data/text/es-S1130-14732009000600008-1.txt
@@ -0,0 +1,8 @@
+A 19-year-old male patient referred from a regional hospital for surgery for hydrocephalus. He had a history of approximately 1 year of left hemicranial headache that worsened on exertion. In recent weeks the headache had increased in intensity and frequency. The neurological examination showed only bilateral papillary oedema.
+The patient provided a magnetic resonance imaging (MRI) scan showing supratentorial ventricular dilatation with an Evans index of 0.43, periependymal clearing in the frontal horn and a small tectal lesion that was not modified by contrast. The fourth ventricle was normal.
+
+With the diagnosis of stenosis of the aqueduct of Sylvius, an endoscopic premamillary ventriculocysternostomy was performed through a right frontal trephine hole according to the standard technique3. A Mayfield clamp (Ohio Medical Instrument Co, Inc., Cincinnati, Oh, USA) was used for head immobilisation. The immediate postoperative period was uneventful, although the patient suffered from headache. Forty-eight hours after surgery and prior to the scheduled discharge from hospital, a new MRI was performed in which the presence of a left parietal epidural haematoma with a mass effect on the ipsilateral lateral ventricle was noted.
+
+A left parietal craniotomy was then performed, showing a perforation that went through the entire bone without affecting the dura mater. The haematoma was drained and a small bleeding dural artery was coagulated. The patient was discharged after 6 days with only some degree of headache. One year after surgery he is asymptomatic and the tectal lesion shows no change on MRI studies.
+
+