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Updated: Feb 28, 2026
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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
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Isolated Fourth Ventricle: To Shunt or Stent.
Aaron Mohanty1, Kim Manwaring2
1Division of Neurosurgery, Department of Surgery, University of Texas Medical Branch, Galveston, Texas.
Operative Neurosurgery (Hagerstown, Md.)
|June 22, 2017
Summary
Fourth ventriculoperitoneal shunts (FVPS) and aqueductal stents (AST) effectively manage isolated fourth ventricle (IFV). The choice depends on aqueductal obstruction extent and ventriculomegaly degree, with FVPS offering greater IFV reduction.
Area of Science:
- Neurosurgery
- Pediatric Neurosurgery
- Hydrocephalus Management
Background:
- Isolated fourth ventricle (IFV) presents management challenges.
- Fourth ventriculoperitoneal shunts (FVPS) and aqueductal stents (AST) are primary treatment options.
- FVPS can be technically demanding with higher complication rates.
Purpose of the Study:
- To evaluate the effectiveness of aqueductal stents (AST) for isolated fourth ventricle (IFV).
- To compare the outcomes of AST versus fourth ventriculoperitoneal shunts (FVPS) in IFV management.
Main Methods:
- Retrospective analysis of 25 patients surgically treated for IFV.
- Preoperative MRI used to assess aqueductal obstruction extent.
- AST placed for short-segment stenosis; FVPS for long-segment obstruction.
Main Results:
- 19 patients received AST, 6 received FVPS.
- Mean follow-up of 45 months.
- Both methods reduced IFV; FVPS showed greater reduction. AST had 2 stent migrations; FVPS had 1 revision and 1 reversible cranial nerve paresis.
Conclusions:
- Both FVPS and AST are effective for IFV.
- Management choice hinges on aqueductal obstruction severity and ventriculomegaly.
- Further research may refine optimal treatment strategies.
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