Endoscopic Laser Fenestration to Treat a Bobble-Head Doll Syndrome Caused by Suprasellar Cyst

Cavalheiro, Sérgio; Costa, Marcos Devanir Silva da; Valsechi, Linoel Curado; Suzuki, Fernando Seiji; Leite, Adriana Lima; Dastoli, Patricia Alessandra; Nicácio, Jardel Mendonça

doi:10.1016/j.wneu.2021.03.037

Cited by 5 publications

(4 citation statements)

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“…3 This inflammation occurs in arachnoiditis, meningeal fibrosis, and subependymal gliosis, impairing flow and resorption of CSF. 14,[18][19][20] As in our case, fourth ventricular trapping can also occur as a result of scarring following posterior fossa tumor surgery. 1,4,10,[18][19][20][21][22][23] The rate of postresection hydrocephalus for tumors in the posterior fossa ranges from 10% to 40% in children.…”

Section: Trapped Fourth Ventriclessupporting

confidence: 67%

“…14,[18][19][20] As in our case, fourth ventricular trapping can also occur as a result of scarring following posterior fossa tumor surgery. 1,4,10,[18][19][20][21][22][23] The rate of postresection hydrocephalus for tumors in the posterior fossa ranges from 10% to 40% in children. 4,[23][24][25] It is likely that tumor location and subtype have some degree of influence on the development of hydrocephalus.…”

Section: Trapped Fourth Ventriclessupporting

confidence: 67%

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Endoscopic placement of a triventricular stent for complex hydrocephalus and isolated fourth ventricle: illustrative case

Horak,

Gulsuna,

LoPresti

et al. 2023

Journal of Neurosurgery: Case Lessons

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BACKGROUND Hydrocephalus is commonly encountered in pediatric neurosurgery. The etiology is diverse, and complexity in management increases in patients with loculated or trapped ventricles. The authors sought to examine a treatment option of endoscopic placement of a triventricular stent in a pediatric patient with complex hydrocephalus and a trapped fourth ventricle. OBSERVATIONS In this case, the authors present the treatment of complex hydrocephalus with a trapped fourth ventricle in a pediatric patient using endoscopic placement of a triventricular aqueductal stent. The patient had a complex neurosurgical history, which included over 15 surgeries for shunted hydrocephalus. This case highlights the unique approach used, and the authors discuss surgical nuances of the technique, as well as learning points. LESSONS Complex hydrocephalus can be difficult to manage because patients often have multiple catheters, loculated or trapped ventricles, and extensive surgical histories. Endoscopic placement of a triventricular stent can decrease shunt system complexity, restore normal cerebrospinal fluid pathway circulation across the cerebral aqueduct, and promote communication between the ventricles. The authors’ treatment modality resulted in the successful resolution of the trapped fourth ventricle and symptomatic improvement in hydrocephalus.

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Section: Trapped Fourth Ventriclessupporting

confidence: 67%

Section: Trapped Fourth Ventriclessupporting

confidence: 67%

Endoscopic placement of a triventricular stent for complex hydrocephalus and isolated fourth ventricle: illustrative case

Horak,

Gulsuna,

LoPresti

et al. 2023

Journal of Neurosurgery: Case Lessons

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show abstract

“…These movements are rhythmic, may intensify during stress, but are partially controllable by the patient and disappear during sleep [11]. At least 81 other cases have already been described before our cases [2,3,5,8,14,15,17,20] which have a particular clinical character due to the predominance of ‛‛non-non laterality movements''. Since the first description in 1966 [1], the consistency of intracerebral cystic abnormalities has been noticed but the direct causal link remains for the moment subject to controversies.…”

Section: Discussionmentioning

confidence: 57%

Bobble Head Doll Syndrome

Haro,

Zabsonre,

Sanou

et al. 2023

roneuro

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Introduction. Bobble head doll syndrome is a neurological syndrome characterized by abnormal involuntary movements of the head combining repetitive or episodic movements of 2 to 3 Hz back and forth in the anterior-posterior direction that can be assimilated to approval movements (yes-yes) and occasionally lateral rotations that can be assimilated to disapproval signs (no-no). It is a rare entity first described by Benton[1]. We describe three cases managed at the Yalgado Ouédraogo University Hospital in Burkina Faso. Observations. Three children, one girl and two boys, aged respectively 5, 9 and 14 years were seen for involuntary abnormal head movements associating lateral rotations assimilated to signs of disapproval (no-no) in two cases, and back and forth movements of the head in one case. In the 14-year-old adolescent, there was also a picture of intracranial hypertension. Clinical examination revealed ataxia and macrocrania in both cases and a syndrome in 1 case. Imaging revealed triventricular hydrocephalus on aqueductal stenosis in all cases with an associated supra sellar cyst in 2 cases. The treatment consisted of endoscopic treatment in 2 cases and ventriculoperitoneal shunt in 1 case. Surgery allowed a considerable regression of involuntary movements of the head in the immediate postoperative period and a complete recovery in the long term. Conclusion. The bobble head doll syndrome is a rare entity related to the consequences of chronic hydrocephalus responsible for abnormal movements whose management done well and early leads to favourable results.

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“…The treatment of BHDS is based on the treatment of the primary lesion, and is usually surgical. It was treated before establishing neuroendoscopic techniques, with open marsupialization or permanent ventriculoperitoneal or cystoperitoneal drainage [8]. Nowadays neuroendoscopic interventions with ventriculocystocisternostomy have gained popularity as a favorable therapeutic option for arachnoid cysts owing to successful results, while being less invasive [9].…”

Section: Discussionmentioning

confidence: 99%

Bobble-head doll syndrome in an infant with an arachnoid cyst: a case report

Doya

Kadri²,

Jouni³

2022

J Med Case Reports

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Background Bobble-head doll syndrome is a rare and unique movement disorder most commonly affecting children younger than 5 years of age. It is characterized by continuous or episodic movement at the frequency of 2–3 Hz. The exact mechanism of bobble-head doll syndrome has not been elucidated. Endoscopic ventriculocisternostomy is the optimal treatment option. In a literature review, there were less than 75 cases of bobble-head doll syndrome with suprasellar arachnoid cyst. Case presentation We report a case of a 1.5-year-old Asian-Syrian girl who presented with a history of excessive head nodding for 3 months that increased with walking, emotions, and stress; decreased during periods of concentration; and was absent during sleep. On physical examination, she was alert and normal, with no medical history. Laboratory assessment and ophthalmological examination were normal. Cranial magnetic resonance imaging demonstrated a well-defined thin-walled suprasellar arachnoid cyst measuring 3 × 5 × 7 cm that obstructed the foramina of Monro, with resulting hydrocephalus ventriculomegaly. The patient underwent endoscopic cystoventriculostomy and cystocisternostomy for the suprasellar arachnoid cyst. During the 6 months of follow-up, the head bobbing disappeared completely, and her growth was normal. Conclusion Despite the rareness of bobble-head doll syndrome, it is considered an important condition that must be investigated early to detect the cause and treated promptly to avoid potential complications.

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Endoscopic Laser Fenestration to Treat a Bobble-Head Doll Syndrome Caused by Suprasellar Cyst

Cited by 5 publications

References 0 publications

Endoscopic placement of a triventricular stent for complex hydrocephalus and isolated fourth ventricle: illustrative case

Endoscopic placement of a triventricular stent for complex hydrocephalus and isolated fourth ventricle: illustrative case

Bobble Head Doll Syndrome

Bobble-head doll syndrome in an infant with an arachnoid cyst: a case report

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