Presentation
Headache and blurring of vision
Patient Data
Marked dilatation of the lateral and 3rd ventricles down to the aqueduct of Sylvius suggesting obstructive non communicating hydrocephalus. Normal 4th ventricular dimension.
The yellow arrow refers to the diaphragm at the mid aqueduct of Sylvius.
Case Discussion
Aqueductal pathology are common causes of obstructive non communicating hydrocephalus characterized by supratentorial ventricular dilatation and normal size 4th ventricle. Note the lack of transependymal spread of CSF, indicating a more insidious / chronic nature of the hydrocephalus. Aqueductal stenosis is the commonest pathology while diaphragm/web are rare. Treatment was done by endoscopy.