Hydrocephalus due to Membranous Obstruction of Magendie's Foramen

Kasapas, Konstantinos; Varthalitis, Dimitrios; Georgakoulias, Nikolaos; Orphanidis, Georgios

doi:10.3340/jkns.2015.57.1.68

Cited by 17 publications

(4 citation statements)

References 7 publications

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“…This was consistent with the findings that was reported by Kasapas et al (6) Additionally, Kasapas et al (6) stated that phase contrast MRI could aid in guiding the appropriate surgical procedure which included incision and removal of membrane with or without ETV or shunting. Our patient however underwent ETV to relieve his symptoms before undergoing the CSF flowmetry (6) .…”

Section: Discussionsupporting

confidence: 90%

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Role of MRI CSF Flowmetry in Evaluation of Hydrocephalus in Pediatric Patients

Abdelhameed

Darweesh

Bedair

2017

Egyptian Journal of Hospital Medicine

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Background: phase contrast MR imaging is a rapid, simple and non-invasive technique which is sensitive to even small CSF flows, and can be used to evaluate CSF flow both qualitatively and quantitatively. Cine phase contrast MR images show CSF flow in a dynamic, more easily appreciable, and in a more pleasing manner, allowing the delineation of obstruction, if present, along the portions of CSF pathway where obstruction is common (foramen of Monro, acqueduct of Sylvius) Patients and Methods: the study includes 20 patients from the pediatric population with ventriculomegaly (diagnosed by a radiological report) referred from Ain Shams Pediatric Hospital, Neurosurgery department at Ain Sahms University, clinic, and outpatients. Control group of 20 pediatric patients of matched age group underwent CSF flow study to obtain normal reference values. These patients had no hydrocephalus and came to our institute to undergo MRI for other neurological causes. CSF flowmetry was added to their study after obtaining oral informed consent from their parents. Results: our study included 20 patients, 8 males and 12 females, with age range 2 months -12 years and average age 3.5 years old. All patients included were diagnosed with hydrocephalus by a previous radiological report. All patients underwent conventional MRI brain and CSF flowmetry. Patients were given diagnosis based on findings of conventional MR images, and were categorized into groups according to their underlying etiologies. 9 patients had aqueductal stenosis, 4 patients had atrophy, 2 patients had communicating hydrocephalus, 2 patients had Arnold Chiari malformation, 1 patient had Dandy-Walker variant, 1 patient had obstruction at foramen of Monro, and 1 had obstruction at foramen of Magendi. CSF flowmetry was added to evaluate the cause of hydrocephalus. Conclusion: phase contrast MR imaging is a rapid, simple and non-invasive technique which is sensitive to even small CSF flows, and can be used to evaluate CSF flow both qualitatively and quantitatively, and could be used in conjunction with conventional MRI in assessment of cases of hydrocephalus.

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Section: Discussionsupporting

confidence: 90%

“…Patients with VP shunts were excluded from the study to avoid any fallacies in measurements that might be caused by the shunt. Velocity measurements of these patients were compared with that of a matched age control group of 10 pediatric patients who did not suffer from hydrocephalus (6) .…”

Section: Discussionmentioning

confidence: 99%

Role of MRI CSF Flowmetry in Evaluation of Hydrocephalus in Pediatric Patients

Abdelhameed

Darweesh

Bedair

2017

Egyptian Journal of Hospital Medicine

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“…meningoencephalitis and arachnoiditis); trauma; postsurgical adhesions; or tumors. [ 7 , 11 , 20 , 25 , 26 , 28 , 38 ]…”

Section: Discussionmentioning

confidence: 99%

Tetraventricular noncommunicating hydrocephalus: Case report and literature review

Rosa

Cruz

Magalhães

et al. 2021

Surgical Neurology International

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Background: Tetraventricular hydrocephalus is a common presentation of communicating hydrocephalus. Conversely, cases with noncommunicating etiology impose a diagnostic challenge and are often neglected and underdiagnosed. Herein, we present a review of literature for clinical, diagnostic, and surgical aspects regarding noncommunicating tetrahydrocephalus caused by primary fourth ventricle outlet obstruction (FVOO), illustrating with a case from our service. Methods: We performed a research on PubMed database crossing the terms “FVOO,” “tetraventriculomegaly,” and “hydrocephalus” in English. Fifteen articles (a total of 34 cases of primary FVOO) matched our criteria and were, therefore, included in this study besides our own case. Results: Most cases presented in adulthood (47%), equally divided between male and female. Clinical presentation was unspecific, commonly including headache, nausea, and dizziness as symptoms (35.29%, 21.57%, and 9.80%, respectively), with ataxic gait (65%) and papilledema (40%) being the most frequent signs. MRI and CT were the imaging modalities of choice (11 patients each), often associated with CSF flow studies, such as cine MRI and CT ventriculogram. Endoscopic third ventriculostomy (ETV) was both the most popular and effective surgical approach (50.85% of cases, with 18.91% of recurrence) followed by ventricle-peritoneal shunt (16.95% of patients, 23.0% of recurrence). Conclusion: FVOO stands for a poorly understood etiology of noncommunicating tetrahydrocephalus. With the use of ETV, these cases, once hopeless, had its morbimortality and recurrence reduced greatly. Therefore, its suspicion and differentiation from other forms of tetrahydrocephalus can improve its natural course, reinforcing the importance of its acknowledgment.

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“…Obstruction distal to the fourth ventricle is a rare cause of hydrocephalus [19]. It can develop through intraventricular membranous obstruction [20,21] or extraventricular compression [22] and in case of Dandy Walker syndrome [26] and Chiari malformation [23][24][25] (see below) [19]. Like all obstructive hydrocephalus, it may also be treated successfully with ventriculostomy, although an additional surgical technique with flexible endoscope is required (see below).…”

Section: Far Distal Obstructionmentioning

confidence: 99%

Presentation of the Success Rate of ETV in Distinct Indication Cases of Hydrocephalus

Oertel¹,

Csokonay²

2018

Hydrocephalus - Water on the Brain

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Endoscopic third ventriculostomy (ETV) is an endoscopic fenestration between the floor of the third ventricle and subarachnoid space. It is the procedure of choice for obstructive hydrocephalus (HC). The indication includes obstructive HC caused by aqueduct stenosis, tumors, brain infarction, cystic lesions, hematoma, postinfectious and posthemorrhagic HC, malformation of the fourth ventricle, and further uncommon indications. In this chapter, surgical techniques and the success rate of ETV in distinct indications will be presented and discussed. The overall success rate of ETV is reported at 60-90%. The outcome of the procedure depends highly on the underlying pathology and age. A very favorable outcome is reported in case of aqueduct stenosis (67-93.5%). High success rate is observed in case of cerebellar infarction (86%), tumors (56-81%), and intraventricular cysts (56-95%). In case of intraventricular hemorrhage (43-73%), infection (60-64%), anatomical aberration (21-80%), and communicating HC (65-72%), a significantly inferior success rate is reported. It is well known that ETV has a lower success rate in children (68-71%) compared to adults (70-90%). The overall high clinical success rate in short-term and long-term follow-up confirms that ETV is the gold standard for treatment of occlusive HC. It is effective, safe, and simple.

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Hydrocephalus due to Membranous Obstruction of Magendie's Foramen

Cited by 17 publications

References 7 publications

Role of MRI CSF Flowmetry in Evaluation of Hydrocephalus in Pediatric Patients

Role of MRI CSF Flowmetry in Evaluation of Hydrocephalus in Pediatric Patients

Tetraventricular noncommunicating hydrocephalus: Case report and literature review

Presentation of the Success Rate of ETV in Distinct Indication Cases of Hydrocephalus

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