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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
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Disproportionately large communicating fourth ventricle with syringomyelia: case report.
Naoshi Hagihara1, Shuji Sakata
1Department of Neurosurgery, Saga Prefectural Hospital Kouseikan, Morodomi-cho,Saga, Japan. hagihan@post.saga-med.ac.jp
Neurologia Medico-Chirurgica
|June 26, 2007
Summary
Syringomyelia in a boy was linked to a large communicating fourth ventricle. Ventriculoperitoneal shunting resolved hydrocephalus, posterior fossa symptoms, and spinal cord abnormalities, indicating a connection between these conditions.
Area of Science:
- Pediatric Neurology
- Neurosurgery
- Neuroimaging
Background:
- Syringomyelia is a rare condition characterized by a fluid-filled cyst within the spinal cord.
- Hydrocephalus involves excess cerebrospinal fluid in the brain, leading to increased pressure.
- Posterior fossa symptoms can arise from structural abnormalities in the lower part of the brain.
Observation:
- A 13-year-old male presented with syringomyelia and a disproportionately large communicating fourth ventricle (DLCFV).
- Clinical manifestations included symptoms of hydrocephalus and typical posterior fossa signs.
- Magnetic resonance imaging (MRI) revealed significant fourth ventricular dilation and syringomyelia.
Findings:
- Ventriculoperitoneal shunting effectively resolved all presenting symptoms.
- Post-shunt placement, MRI demonstrated resolution of ventricular and spinal cord abnormalities.
- Cine MRI before and after surgery showed altered cerebrospinal fluid flow at the foramen magnum.
Implications:
- This case suggests DLCFV can cause or be associated with syringomyelia.
- Ventriculoperitoneal shunting is an effective treatment for this specific combination of conditions.
- Understanding cerebrospinal fluid dynamics is crucial for managing syringomyelia associated with fourth ventricular dilation.
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