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Venous lesions as a cause of sylvian aqueductal obstruction: case report
Alexandre V Giannetti1, Rachael B M Rodrigues, Felipe P Trivelato
1Division of Neurosurgery, Federal University of Minas Gerais, Belo Horizonte, Brazil. agjg@zaz.com.br
Objective:
The cases of two patients who presented with sylvian aqueductal obstruction caused by venous lesions (an ectatic vein and a developmental venous anomaly, which are uncommon causes of obstructive hydrocephalus) are reported.
Clinical Presentation:
A 42-year-old man presented with chronic headache and behavior abnormalities. Magnetic resonance imaging revealed supratentorial ventricular dilation caused by an obstruction of the sylvian aqueduct by a developmental venous anomaly. An 18-year-old man complained of intermittent headaches. The magnetic resonance imaging scan disclosed aqueductal stenosis-type hydrocephalus secondary to an ectatic vein.
Intervention:
Both patients underwent endoscopic third ventriculostomy and recovered well. During the procedures, the aqueductal obstruction by venous elements could be seen clearly.
Conclusion:
Venous anomalies may cause obstructive hydrocephalus and can be suspected in cases of chronic and intermittent headaches. Endoscopic third ventriculostomy is an effective treatment.