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Aqueductal stenosis 9 years after mumps meningoencephalitis: treatment by endoscopic third ventriculostomy
Giuseppe Cinalli1, Pietro Spennato, Claudio Ruggiero
1Department of Pediatric Neurosurgery, Santobono Children's Hospital, Naples, Italy. gcinall@tin.it
Introduction:
Hydrocephalus due to aqueductal stenosis following mumps meningoencephalitis is a rare condition, reported only in 16 cases in the literature. The pathogenetic role of the mumps virus in inducing aqueductal stenosis has been demonstrated experimentally in animal models and clinically proven in a few cases. Although obstructive in nature, the post-infectious etiology raises the question as to whether third ventriculostomy is the appropriate treatment.
Patient:
We report a case of hydrocephalus due to pure aqueductal stenosis occurring in an 11-year-old boy who suffered from mumps meningoencephalitis 9 years previously. The boy was successfully treated by endoscopic third ventriculostomy.
Conclusions:
The present case offers further evidence of the purely obstructive nature of the hydrocephalus induced by paramyxovirus meningoencephalitis, even if it did occur several years after the infectious disease. The pathogenesis of mumps-induced hydrocephalus and the rationale of treatment are discussed, and the literature is reviewed.
Insights
Mumps meningoencephalitis can cause rare obstructive hydrocephalus due to aqueductal stenosis years later. Endoscopic third ventriculostomy proved effective in treating this condition in a pediatric case.
Area of Science:
- Neurology
- Pediatrics
- Infectious Diseases
Background:
- Hydrocephalus secondary to aqueductal stenosis following mumps meningoencephalitis is exceptionally rare.
- The mumps virus's role in aqueductal stenosis is supported by animal models and limited clinical data.
- The post-infectious nature prompts discussion on optimal treatment, specifically endoscopic third ventriculostomy.
Observation:
- A case study of an 11-year-old boy with hydrocephalus due to pure aqueductal stenosis is presented.
- The patient had a history of mumps meningoencephalitis nine years prior to presentation.
- Successful treatment was achieved using endoscopic third ventriculostomy.
Findings:
- This case reinforces that hydrocephalus induced by paramyxovirus meningoencephalitis can be purely obstructive.
- The obstructive effects may manifest years after the initial infection.
- Endoscopic third ventriculostomy is a viable treatment option for this rare condition.
Implications:
- Further supports the obstructive etiology of mumps-induced hydrocephalus.
- Highlights the long-term neurological sequelae of mumps meningoencephalitis.
- Validates endoscopic third ventriculostomy as a treatment for post-infectious aqueductal stenosis.
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