Obstructive Hydrocephalus in Childhood

Abstract

The differential diagnosis of obstructive hydrocephalus in childhood involves a consideration of two main groups of cases, cerebellar tumours and obstructive lesions of a non-neoplastic nature. The most common of the non-neoplastic conditions are stenosis of the aqueduct of Silvius and obliteration of the outlet of the fourth ventricle.In the literature on obstructive hydrocephalus the radiological distinctions between the neoplastic and the non-neoplastic groups have been well drawn mainly by improved techniques in ventriculography. The pathological aspects have been described by Russell (1949) Matria Twenty-three cases were studied, 15 with cerebellar tumours and eight with non-neoplastic obstructions; of the latter four were stenoses of the aqueduct and four occlusion of the foramina of the fourth ventricle. The ages in the two groups were comparable, varying from 3 to 15 years.The tumours were either medulloblastomas or astrocytomas, the obstructions in the fourth ventricle were all caused by arachnoid adhesions, the type produced by congenital atresia not being represented. The aetiology in the aqueduct stenosis group is not known but is usually a subependymal gliosis of uncertain origin.