Idiopathic Unilateral Foramen of Monro Stenosis: Neuroimaging Findings in Three Patients

Boruah, Deb Kumar; Arora, Monali; Prakash, Arjun; Baishya, Hiranya; Chakraborty, Pratik

doi:10.18410/jebmh/2016/374

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…The patient showed positive CSF flow on cine images and normal PSV through the aqueduct of Sylvius, yet no CSF flow was noted through the right foramen of Monro. This was consistent with Boruah et al (7) , who reported similar findings in 3 patients. Also, phase contrast MRI plays an important role in follow-up of patients after surgery to evaluate the efficacy of the procedure (7) .…”

Section: Discussionsupporting

confidence: 93%

“…This was consistent with Boruah et al (7) , who reported similar findings in 3 patients. Also, phase contrast MRI plays an important role in follow-up of patients after surgery to evaluate the efficacy of the procedure (7) .…”

Section: Discussionsupporting

confidence: 93%

“…In the setting of non-communicating hydrocephalus, phase contrast MRI plays an important role in determining the level of obstruction, thus providing a useful tool that guides appropriate surgical procedures for the patients. Our study included 11 patients diagnosed with non-communicating hydrocephalus; 9 were diagnosed with aqueductal stenosis, 1 was diagnosed with formamen of Monro obstruction, and 1 was diagnosed with foramen of Magendi obstruction (7) .…”

Section: Discussionmentioning

confidence: 99%

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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: 93%

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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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Phase-contrast magnetic resonance imaging in evaluation of hydrocephalus in pediatric patients

Sakr¹,

Hamisa

Sawaf

et al. 2023

Egypt J Radiol Nucl Med

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Background Hydrocephalus is an increase in cerebrospinal fluid volume leading to cerebral ventricular enlargement (ventriculomegaly). Phase-contrast magnetic resonance imaging is a sensitive technique to cerebrospinal fluid flow allowing noninvasive quantitative and qualitative evaluation of cerebrospinal fluid flow. Aim The purpose of our study was to assess the role of cerebrospinal fluid flowmetry using phase-contrast magnetic resonance imaging in evaluation of hydrocephalus in pediatric patients. Methods This prospective study included a group of 50 patients with ventriculomegaly diagnosed by a previous magnetic resonance imaging study. A control group of 20 subjects of matched age group were also included. All the participants were subjected to cerebrospinal fluid flow study. Results After quantitative assessment of cerebrospinal fluid flow at aqueduct level, the mean values of flow and velocity parameters were compared in both patients and control groups. The mean values in patients with aqueduct stenosis and Dandy–Walker malformation were significantly lower than those of the control group (no flow with hypodynamic circulation) with p < 0.001, < 0.017 for mean velocity, respectively, the mean values in patients with brain atrophy and Arnold–Chiari malformation, bilateral obstructive hydrocephalus at foramen of Monro were significantly lower than those of the control group (diminished flow with hypodynamic circulation) with p < 0.001, < 0.001, 0.046 for mean velocity, respectively, and 0.002, 0.001, 0.160 for stroke volume, respectively, the mean values in patients with communicating hydrocephalus and unilateral obstructive hydrocephalus at foramen of Monro were significantly higher than those of the control group (hyperdynamic flow) with p < 0.001 for mean velocity and stroke volume, and the mean values in patients with arachnoid cysts were within normal as compared to control group (normal dynamic flow). Conclusion Phase-contrast magnetic resonance imaging is a noninvasive technicality used for evaluation of cerebrospinal fluid flow both qualitatively and quantitatively for determining the type of hydrocephalus seen.

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Surgical treatment of patients with idiopathic obstruction of the foramen of Monro

Shevchenko

Shimanskiy

Poshataev

et al. 2022

Nejrohirurgiâ (Mosk.)

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Introduction. Idiopathic obstruction of the foramen of Monroe is an extremely rare pathology in adults and accounts for 1 % of all forms of occlusive hydrocephalus. The largest described series of patients with such pathology includes 4 adult patients. Four types of the foramen of Monro obstruction have been distinguished: type A – atresia, or stenosis, type B – morphological obstruction (membrane), type C – functional obstruction, type D – patent foramen. These patients usually undergo endoscopic or shunting surgery. Currently no algorithm exists for the treatment of such patients.Materials and methods. From 2004 to 2019 year 251 adult patients with idiopathic hydrocephalus were treated at the N. N. Burdenko National Medical Research Center of Neurosurgery. Of these, 11 people (4.4 %) had signs of obstruction at the level of the foramen of Monro. The average age of the patients was 41.9 years (25–67 years). The condition was more prevalent among women (8 female, 3 male patients). The most common symptoms were headaches and nausea. None of the patients showed signs of intracranial hypertension upon examination of the fundus. Magnetic resonance imaging of the brain demonstrated expansion of one or both of the lateral ventricles, stenosis of foramina of Monro, or their occlusion by membranes.Results. Patients were divided into 3 groups depending on the type of foramen of Monro obstruction. Type A obstruction was observed in 8 patients: in patients with unilateral obstruction (3 patients), only septostomy was performed, while among the patients with bilateral obstruction, 3 patients underwent septostomy followed by reconstruction and stenting of the right foramen of Monro (1 of these patients later required a shunting procedure), and in 2 patients, a shunting procedure was performed at initial presentation. Type B obstruction was observed in 2 patients: a patient with unilateral obstruction underwent septostomy and dissection of the membrane, and 1 patient with bilateral obstruction underwent septostomy, dissection of the membrane, and foraminal stenting. In a patient with type C obstruction, a septostomy and stenting of the right foramen of Monro were performed. Based on postoperative MRI data, the dimensions of the ventricles of the brain decreased or did not change. Most patients showed a complete regression of symptoms or their significant reduction, while one patient’s condition stabilized after surgery. There were no fatal outcomes or persistent complications. The follow-up period ranged from 4 to 60 months (29.4 months on average).Conclusion. In cases of idiopathic obstruction of the foramen of Monro, endoscopic surgery can be used as the treatment of choice.

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Idiopathic Unilateral Foramen of Monro Stenosis: Neuroimaging Findings in Three Patients

Cited by 4 publications

References 15 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

Phase-contrast magnetic resonance imaging in evaluation of hydrocephalus in pediatric patients

Surgical treatment of patients with idiopathic obstruction of the foramen of Monro

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