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[Disproportionately large, communicating fourth ventricle. Case report].

Y Shose1, H Nogaki, S Kamikawa

  • 1Department of Neurosurgery, Toyooka Public Hospital, Hyogo.

Neurologia Medico-Chirurgica
|December 1, 1991
PubMed
Summary
This summary is machine-generated.

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A disproportionately large, communicating fourth ventricle (DLCFV) can cause neurological symptoms. Prompt cerebrospinal fluid diversion relieved symptoms, highlighting the importance of differentiating DLCFV from isolated fourth ventricles.

Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • A 39-year-old male presented with progressive neurological deficits including altered consciousness, diplopia, and ataxia.
  • Previous interventions included ventriculoperitoneal shunting and arteriovenous malformation removal.

Observation:

  • Neurological examination revealed drowsiness, nystagmus, Parinaud's sign, and truncal ataxia.
  • CT scan showed marked dilatation of the fourth ventricle, disproportionate to other ventricles, with cerebellar hypodensities.

Findings:

  • External ventricular drainage (EVD) insertion led to ventricular size reduction and symptom resolution.
  • The aqueductal canal was confirmed to be patent, distinguishing the condition from isolated fourth ventricle.

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Implications:

  • The study highlights the clinical significance of disproportionately large, communicating fourth ventricle (DLCFV).
  • Proposed mechanism involves pressure-induced fragility of cerebellar parenchyma surrounding the fourth ventricle.
  • Differentiating DLCFV from isolated fourth ventricle is crucial for appropriate management.