Late Presentation of Congenital Aqueduct Stenosis in Adulthood with High-Riding Basilar Artery: Case Report

Overview

Journal J Neurol Surg Rep

Publisher Thieme

Date 2025 Jan 21

PMID 39835160

Authors

Hassan Mohammed Alturiki

Batool M Alqudihi

Shima Alboesa

Abdullah H Alramadan

Affiliations

Soon will be listed here.

Abstract

A rare variant of congenital aqueductal stenosis (CAS) is known as adult-onset CAS, characterized by the emergence of symptoms during adulthood. A 35-year-old man presented complaining of acute-onset headache and vomiting. Magnetic resonance imaging of the brain revealed an acute hydrocephalus due to an aqueductal web. The patient was treated with a ventriculoperitoneal shunt and doing well. His condition was complicated by subdural hematoma as a result of overshunting, which was treated by frontoparietal craniotomy and eventually, he underwent valve revision to a programmable valve. Additional research is needed to gain a deeper understanding of the hypothesis related to adult aqueductal stenosis. This will help shed light on the asymptomatic childhood phase and potentially reduce complications by identifying late CAS early.

References

Tisell M, Tullberg M, Hellstrom P, Blomsterwall E, Wikkelso C . Neurological symptoms and signs in adult aqueductal stenosis. Acta Neurol Scand. 2003; 107(5):311-7. DOI: 10.1034/j.1600-0404.2003.00124.x. View

Brar K, Sharma A, Nathan A . A rare case of congenital aqueductal stenosis. Med J Armed Forces India. 2014; 69(2):181-3. PMC: 3862368. DOI: 10.1016/j.mjafi.2012.02.002. View

Tisell M . How should primary aqueductal stenosis in adults be treated? A review. Acta Neurol Scand. 2005; 111(3):145-53. DOI: 10.1111/j.1600-0404.2005.00379.x. View

Algin O, Hakyemez B, Parlak M . Phase-contrast MRI and 3D-CISS versus contrast-enhanced MR cisternography on the evaluation of the aqueductal stenosis. Neuroradiology. 2009; 52(2):99-108. DOI: 10.1007/s00234-009-0592-x. View

Harrison M, Robert C, Uttley D . Benign aqueduct stenosis in adults. J Neurol Neurosurg Psychiatry. 1974; 37(12):1322-8. PMC: 1083646. DOI: 10.1136/jnnp.37.12.1322. View

Muzumdar D, Nadkarni T, Goel A . Spontaneous cerebrospinal fluid rhinorrhea as a presenting symptom of aqueductal stenosis--case report. Neurol Med Chir (Tokyo). 2004; 43(12):626-9. DOI: 10.2176/nmc.43.626. View

Algin O, Ozmen E . Heavily T2W 3D-SPACE images for evaluation of cerebrospinal fluid containing spaces. Indian J Radiol Imaging. 2012; 22(1):74-5. PMC: 3354364. DOI: 10.4103/0971-3026.95410. View

Verhagen W, Bartels R, Fransen E, Van Camp G, Renier W, Grotenhuis J . Familial congenital hydrocephalus and aqueduct stenosis with probably autosomal dominant inheritance and variable expression. J Neurol Sci. 1998; 158(1):101-5. DOI: 10.1016/s0022-510x(98)00097-5. View

Sternbach G . Subdural hematoma in a shunted patient. J Emerg Med. 2005; 29(4):483-4. DOI: 10.1016/j.jemermed.2005.05.008. View

10.

Fukuhara T, Luciano M . Clinical features of late-onset idiopathic aqueductal stenosis. Surg Neurol. 2001; 55(3):132-6; discussion 136-7. DOI: 10.1016/s0090-3019(01)00359-7. View

11.

Xie J, Donaldson L, Margolin E . Papilledema: A review of etiology, pathophysiology, diagnosis, and management. Surv Ophthalmol. 2021; 67(4):1135-1159. DOI: 10.1016/j.survophthal.2021.11.007. View

12.

Rodis I, Mahr C, Fehrenbach M, Meixensberger J, Merkenschlager A, Bernhard M . Hydrocephalus in aqueductal stenosis--a retrospective outcome analysis and proposal of subtype classification. Childs Nerv Syst. 2016; 32(4):617-27. DOI: 10.1007/s00381-016-3029-y. View

13.

Lynch D, Mehta S, Shah K, Toscano D, Pruitt R, Woo H . Endoscopic Third Ventriculostomy Using Penumbra Artemis™ Neuro Evacuation Device: Technical Case Report and Operative Video. Cureus. 2023; 15(9):e45761. PMC: 10590497. DOI: 10.7759/cureus.45761. View

14.

Algin O, Turkbey B . Evaluation of aqueductal stenosis by 3D sampling perfection with application-optimized contrasts using different flip angle evolutions sequence: preliminary results with 3T MR imaging. AJNR Am J Neuroradiol. 2011; 33(4):740-6. PMC: 8050433. DOI: 10.3174/ajnr.A2833. View

15.

Little J, Houser O, MacCARTY C . Clinical manifestations of aqueductal stenosis in adults. J Neurosurg. 1975; 43(5):546-52. DOI: 10.3171/jns.1975.43.5.0546. View

16.

Kumar S, Sahana D, Rathore L, Jain A, Tawari M, Singh D . Extra-axial endoscopic third ventriculostomy: preliminary experience with a technique to circumvent conventional endoscopic third ventriculostomy complications. J Neurosurg. 2022; 138(2):503-513. DOI: 10.3171/2022.5.JNS22589. View