Aqueduct stenosis

Case contributed by A.Prof Frank Gaillard

Presentation

Headaches

Patient Data

Age: 25
Gender: Female
MRI

The lateral and third ventricles are markedly enlarged with evidence of transependymal oedema and effacement of the cortical sulci. The aqueduct is stenosed in its middle third and no flow through it is evident on CSF flow studies. The tectal plate appears normal. 

Flow does appear to extend through the third ventricular floor, although this could represent pulsation on the inferiorly displaced floor by the adjacent basilar artery. 

Annotated image

Enlarged third ventricle with expansion of the supraoptic recess (SOR), infundibular recess (IR) and pineal recess (PR). Basilar tip (red arrow) is closely related to the inferiorly displaced floor of the the third ventricle. 

On flow studies flow induced signal can be seen passing in front of the basilar tip and into the third ventricle. 

Case Discussion

The patient went on to have a third ventriculostomy which confirmed the presence of a pin-hole defect in the floor of the third ventricle, inadequate for treatment of non-communicating hydrocephalus. This was endoscopically enlarged and the patient has made an uneventful recovery. 

PlayAdd to Share

Case information

rID: 34874
Case created: 12th Mar 2015
Last edited: 17th Feb 2016
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.