A case of congenital obstruction of magendie’s foramen: embryologic analysis and treatment

Abstract

Background: Fourth ventricle isolated Magendie's foramen primitive obstruction is rare. The etiology and the pathophysiology of the constitution of this obstruction in congenital cases remain elusive. We report a case of congenital obstruction of Magendie's foramen in an adult patient and discuss the embryogenic mechanism and our management of this rare pathology. Case presentation: A 20 years old female patient without any medical history was referred for headaches and vomiting. Emergency CT scan revealed major hydrocephalus subsequently she underwent a ventriculoperitoneal shunt as initial treatment. The diagnosis of fourth ventricle obstruction was made 5 months later when the patient came back complaining of headaches, cerebellar signs and cystic dilatation of the fourth ventricle on CT scan and MRI. Fourth ventricle Magendie's foraminoplasty via classic posterior fossa surgery brings complete cure. Conclusion: Magendie's foramen obstruction is rare. The embryological development of the posterior fossa and its content could explain the primitive obstruction which can be managed by classic surgery in case of unavaibility of endoscopy.