Postnatal development of Blake’s pouch cyst: a case report and new insight for its pathogenesis

Hirono, Shuichi; Ito, Daisuke; Murai, Hisayuki; Kobayashi, Masayoshi; Suyama, Maiko; Fujii, Kiyotaka; Saeki, Naokatsu

doi:10.1007/s00381-014-2458-8

Cited by 15 publications

(8 citation statements)

References 10 publications

(21 reference statements)

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“…Hirono reported a child case of BPC that was not present at 8 months and appeared at age of 3 years, suggesting the presence of secondary BPC. [ 7 ] In this case, the BPC was manifested due to a brain tumor, which disseminated ventricle wall widely and obstructed the CSF. However, as many case reports, including our case, the late manifestation of BPC remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic third ventriculostomy for patients with Blake’s pouch cyst with adult-onset hydrocephalus: Importance of improved cerebrospinal fluid flow in the prepontine cistern – A case report

Hori

Akai

Shiraishi

et al. 2023

Surgical Neurology International

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Background: Blake’s pouch cyst (BPC) is a posterior fossa cystic malformation that commonly occurs in children with rare adult onset. Herein, we report a case of adult onsets BPC. Case Description: A 61-year-old man presented with gait and cognitive disturbance. Preoperative magnetic resonance imaging (MRI) revealed scarring in the prepontine cistern, and cine phase-contrast MRI revealed no pulsation. Endoscopic third ventriculostomy (ETV) was performed with opening the scarring in the prepontine cistern. Postoperative cine phase-contrast MRI revealed that cerebrospinal fluid (CSF) flow in the prepontine cistern improved, resolving the patient’s symptoms. Conclusion: We report a case of adult-onset BPC. The mechanism by which is becomes symptomatic is still unclear. We opened the scar in prepontine cistern in addition to ETV with good results. In this report, we discussed the importance of the improvement in CSF dynamics in the prepontine cistern.

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Section: Discussionmentioning

confidence: 99%

Endoscopic third ventriculostomy for patients with Blake’s pouch cyst with adult-onset hydrocephalus: Importance of improved cerebrospinal fluid flow in the prepontine cistern – A case report

Hori

Akai

Shiraishi

et al. 2023

Surgical Neurology International

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“…Hirono et al reported a case of postnatal development of hydrocephalus with BPC in conjunction with pilomyxoid astrocytoma, despite the presence of normal neuroimaging twice beforehand. 13 Still, the possibility of postnatal re-expansion of BPC cannot exclude hydrocephalus developing from continued nusinersen administration. The exact effect of nusinersen related to changes in CSF dynamics has not been well described, partly because it is a relatively new drug and has been used only in a small number of SMA patients.…”

Section: Discussionmentioning

confidence: 99%

Hydrocephalus in Spinal Muscular Atrophy: A Case Report and Review of the Literature

Sah

Abrams

Chari

et al. 2020

Journal of Pediatric Neurology

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In this article, we reported a case of spinal muscular atrophy (SMA) type I noted to have tetraventricular hydrocephalus with Blake's pouch cyst at 8 months of age following intrathecal nusinersen therapy. The association of hydrocephalus with SMA is rarely reported in the literature. Development of hydrocephalus after intrathecal nusinersen therapy is also reported in some cases, but a cause–effect relationship is not yet established. The aim of this study was to describe the clinical characteristics of a patient with SMA type I and hydrocephalus, to review similar cases reported in the literature, and to explore the relationship between nusinersen therapy and development of hydrocephalus. The clinical presentation and radiographic findings of the patient are described and a comprehensive review of the literature was conducted. The adverse effect of communicating hydrocephalus related to nusinersen therapy is being reported and the authors suggest carefully monitoring for features of hydrocephalus developing during the course of nusinersen therapy.

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“…These authors found a hard membrane in the prepontine cistern and confirmed pulsatile movement of the third ventricular floor after perforating this membrane. Hirono et al 7) described a 3-year-old girl with BPC-associated hydrocephalus suffering from headaches and nausea. ETV was initially performed, but the patient developed bacterial meningitis and secondary hydrocephalus, which necessitated a VPS 1 month after the ETV.…”

Section: Discussionmentioning

confidence: 99%

“…2,3) Although the pathophysiology and optimal treatment for hydrocephalus with BPC remains controversial, shunt placement, endoscopic third ventriculostomy (ETV), and fenestration of the cyst have been previously reported. 2,[4][5][6][7][8][9] ETV has been reported to be effective in pediatric patients with BPCassociated hydrocephalus in recent years. 4,6,10) In line with the current trend of using minimally invasive procedures in neurosurgery, ETV is considered a good alternative for hydrocephalus with BPC.…”

Section: Introductionmentioning

confidence: 99%

Progressive Hydrocephalus after Endoscopic Third Ventriculostomy in Pediatric Patients with Blake’s Pouch Cyst

Takeuchi

Kimiwada

Shirane

et al. 2020

NMC Case Report Journal

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The pathophysiology and optimal treatment for hydrocephalus with Blake’s pouch cyst (BPC) remain controversial. The authors present two pediatric cases of hydrocephalus associated with BPC, in which the patients’ hydrocephalus progressed after endoscopic third ventriculostomy (ETV), despite a patent stoma of the third ventricular floor. Case 1: A 4-year-old girl with delayed gait development was diagnosed with BPC-associated hydrocephalus and received ETV. Postoperatively, the patient presented headaches and nausea. Computed tomography (CT) scans demonstrated larger ventricles than those observed on the preoperative images. Because phase-contrast cine magnetic resonance imaging (MRI) and constructive interference in steady state (CISS) MRI revealed patent cerebrospinal fluid (CSF) flow at the third ventricular floor level, a ventriculoperitoneal shunt (VPS) was placed using a programmable pressure valve to treat the hydrocephalus. Case 2: A 6-year-old girl with newly developed repeated convulsive seizures was diagnosed with BPC-associated hydrocephalus and received ETV. Phase-contrast cine MRI on the 5th postoperative day showed hyperdynamic CSF flow at the third ventricular floor level. She also developed vomiting and headache 6 weeks after ETV. CT scans demonstrated much larger tetraventricular hydrocephalus than that observed on the preoperative images. VPS placement improved her hydrocephalus. Referencing the previous literature, we discuss the CSF dynamics and the mechanism of BPC-associated hydrocephalus, focusing on the third ventricular floor bulging. We hope our experience will help elucidate the pathophysiology and treatment strategies for BPC-associated hydrocephalus.

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Postnatal development of Blake’s pouch cyst: a case report and new insight for its pathogenesis

Cited by 15 publications

References 10 publications

Endoscopic third ventriculostomy for patients with Blake’s pouch cyst with adult-onset hydrocephalus: Importance of improved cerebrospinal fluid flow in the prepontine cistern – A case report

Endoscopic third ventriculostomy for patients with Blake’s pouch cyst with adult-onset hydrocephalus: Importance of improved cerebrospinal fluid flow in the prepontine cistern – A case report

Hydrocephalus in Spinal Muscular Atrophy: A Case Report and Review of the Literature

Progressive Hydrocephalus after Endoscopic Third Ventriculostomy in Pediatric Patients with Blake’s Pouch Cyst

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