Intraventricular Bone Dust Migration after Endoscopic Third Ventriculostomy: Illustrative Report of 2 Cases.

Introduction: Autologous bone dust replacement is a commonly used technique to seal a defect created from a burr hole. However, postoperative migration of these bone fragments may occur as an uncommon complication of endoscopic third ventriculostomy (ETV).

Case Presentation: We report 2 cases of intraventricular bone dust migration resulting in acute hydrocephalus from physical obstruction of the stoma and infection.

Discussion/conclusion: From our 2 cases as well as other reported cases, the bone dust may have acted as a foreign body and served as a nidus of infection, in addition to causing physical obstruction. A lumbar puncture performed after ETV may have resulted in a suction effect of the bone dust from the burr hole into the ventricular system. Both our cases necessitated urgent surgical intervention to extract the bone fragments and restore CSF flow. Because of its potential complications, we recommend against using autologous bone dust for closure of a burr hole defect after ETV.