Idiopathic Fourth Ventricle Outlet Obstruction Successfully Treated by Endoscopic Third Ventriculostomy: a Case Report

Overview

Journal Springerplus

Date 2015 Nov 7

PMID 26543700

Citations 6

Authors

Yukitomo Ishi

Katsuyuki Asaoka

Hiroyuki Kobayashi

Hiroaki Motegi

Taku Sugiyama

Yuka Yokoyama

Sumire Echizenya

Koji Itamoto

Affiliations

Soon will be listed here.

Abstract

Introduction: Fourth ventricle outlet obstruction (FVOO) is a rare cause of obstructive hydrocephalus. We describe a case of idiopathic FVOO that was successfully treated with endoscopic third ventriculostomy (ETV).

Case Report: A 3-year old boy without any remarkable medical history presented with a headache and vomiting. Computed tomography (CT) images, which had incidentally been taken 2 years previously due to a minor head injury, showed no abnormality. Magnetic resonance imaging on admission showed tetra-ventricular hydrocephalus associated with the dilatation of the fourth ventricle outlets, without any obstructive lesions. However, CT ventriculography, involving contrast medium injection through a ventricular catheter, suggested mechanical obstruction of the cerebrospinal fluid (CSF) at the fourth ventricle outlets. Thus, the patient was diagnosed with FVOO and ETV was performed; the hydrocephalus was subsequently resolved. Although hydrocephalus recurred 1 year postoperatively, re-ETV for the highly stenosed fenestration successfully resolved this condition.

Conclusions: ETV should be considered for FVOO treatment, particularly in idiopathic cases without CSF malabsorption.

Citing Articles

The endoscopic treatment of fourth ventricle outlet obstruction: Report of two children and systematic review.

Mulhem A, Alsulaiman A, Hammersen S, Kantelhardt S Clin Case Rep. 2023; 11(12):e8234.

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Late-onset obstructive hydrocephalus associated with occipital encephalocele with large skull defect successfully treated by endoscopic third ventriculostomy.

Munekata Y, Sugiyama T, Ueda Y, Mizushima M, Motegi H, Fujimura M Childs Nerv Syst. 2022; 39(1):307-310.

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Tetraventricular noncommunicating hydrocephalus: Case report and literature review.

Rosa M, Cruz T, Magalhaes Junior E, Nigri F Surg Neurol Int. 2021; 12:519.

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Endoscopic Third Ventriculostomy in the Fourth Ventricle Outlet Obstruction Associated with Chiari Malformation Type I and Syringomyelia: Case Report.

Salem-Memou S, Amal T, Salihy S, Soumare O, Najat B Asian J Neurosurg. 2021; 16(1):170-173.

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Cuoco J, Benko M, Klein B, Keyes D, Patel B, Witcher M Surg Neurol Int. 2020; 11:305.

PMID: 33093982 PMC: 7568106. DOI: 10.25259/SNI_408_2020.

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