Postulating the concept of compensated trapped fourth ventricle: a case-based demonstration with long-term clinicoradiological follow-up

Udayakumaran, Suhas; Panikar, Dilip

doi:10.1007/s00381-012-1712-1

Cited by 6 publications

(3 citation statements)

References 13 publications

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“…On these grounds, strict indications for treatment are advocated. 28 In our case, the clinical and neurological status remained stable for a long time until the onset of new symptoms of oculomotor impairment and mild increase of the fourth ventricle dilation. The main treatment options consist of microsurgical fenestration through a posterior fossa craniotomy/craniectomy with or without placement of a stent to the spinal subarachnoid space, to achieve a diversion of CSF, or a fourth ventricle shunt, either separate or connected via a Y-shaped connector with a supratentorial ventricular catheter.…”

Section: Discussionsupporting

confidence: 49%

Descending transtentorial herniation, a rare complication of the treatment of trapped fourth ventricle: case report

Frassanito

Markogiannakis

Bonaventura

et al. 2015

PED

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Descending transtentorial herniation (DTH) is a complication of raised pressure in the supratentorial compartment, usually resulting from mass lesion of several etiologies. The authors report an exceptional case of DTH complicating the implant of a CSF shunting device in the trapped fourth ventricle of a 17-year-old boy in whom a second CSF shunting device had been implanted for neonatal posthemorrhagic and postinfectious hydrocephalus. The insidious clinical and radiological presentation of DTH, mimicking a malfunction of the supratentorial shunt, is documented. Ultimately, the treatment consisted of removal of the infratentorial shunt and endoscopic acqueductoplasty with stenting. The absence of supratentorial mass lesion and other described etiologies of DTH prompted the authors to speculate on the hydrodynamic pathogenesis of DTH in the present case.

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Section: Discussionsupporting

confidence: 49%

Descending transtentorial herniation, a rare complication of the treatment of trapped fourth ventricle: case report

Frassanito

Markogiannakis

Bonaventura

et al. 2015

PED

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“…They stressed that the term isolated fourth ventricle should be used only for patients with previous CSF shunt. However, IFV without history of CSF shunt is common [6]. Hawkins stressed that IFV was associated with small lateral ventricles [7].…”

Section: Discussionmentioning

confidence: 99%

“…Hawkins stressed that IFV was associated with small lateral ventricles [7]. However, it is not uncommon in the literature that IFV includes the disproportionately enlarged fourth ventricle coexisting with normal-sized or enlarged third and lateral ventricles [2, 6, 8–11]. Qi and Matsumoto proposed the concept of functional obstruction of aqueduct [12].…”

Section: Discussionmentioning

confidence: 99%

Disproportionately large communicating fourth ventricle: two case reports

Lyu

Wang

et al. 2019

J Med Case Reports

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Background: Management of the disproportionately large communicating fourth ventricle is still problematic. Case presentation: Two cases of disproportionately large communicating fourth ventricle were treated successfully. One was a case of a 51-year-old Han Chinese woman with a complaint of headache and dizziness of 1 year's duration. Magnetic resonance imaging (MRI) demonstrated hydrocephalus with a disproportionately large fourth ventricle. She underwent a ventriculo-peritoneal shunt of the right lateral ventricle. Her symptoms were relieved totally. Five years later, magnetic resonance imaging showed she had a normal ventricular system. The other case was a 24-year-old Han Chinese man with a 2-month history of headache and dizziness accompanied by progressive loss of bilateral vision. Magnetic resonance imaging revealed hydrocephalus with a disproportionately large fourth ventricle, crowded posterior cranial fossa, and syringomyelia extending from C1 to C5. He underwent suboccipital and C1 decompression and duraplasty. Shortly after the surgery, his symptoms were relieved completely, the syringomyelia completely disappeared, and the fourth ventricle became significantly smaller. Conclusions: The management of the disproportionately large communicating fourth ventricle should be individualized. If it coexists with crowded posterior cranial fossa or syringomyelia, posterior fossa decompression could be an option for initial management. If there is no sign of crowded posterior cranial fossa or syringomyelia, shunt of the lateral ventricles might be the first choice.

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Aqueductoplasty and Aqueductal Stenting

Fleck¹,

Schroeder²

2019

Pediatric Hydrocephalus

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Postulating the concept of compensated trapped fourth ventricle: a case-based demonstration with long-term clinicoradiological follow-up

Abstract: We demonstrate and describe a compensated TFV and reiterate that a TFV is a functional concept with imaging being at most only corroboratory.

Cited by 6 publications

References 13 publications

Descending transtentorial herniation, a rare complication of the treatment of trapped fourth ventricle: case report

Descending transtentorial herniation, a rare complication of the treatment of trapped fourth ventricle: case report

Disproportionately large communicating fourth ventricle: two case reports

Aqueductoplasty and Aqueductal Stenting

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