Aqueduct stenosis

Case contributed by Frank Gaillard
Diagnosis almost certain


Incidental finding when imaged for minor head trauma.

Patient Data

Age: 50 years
Gender: Male

Non-contrast CT demonstrates marked dilatation of the lateral and third ventricles as well as the superior part of the aqueduct of Sylvius. The fourth ventricle posterior fossa basal cisterns are unremarkable, and the cortical sulci are effaced. There is no transependymal edema. The septum pellucidum is fenestrated. 

Annotated image

Markedly dilated lateral ventricles ( * ) with fenestration of the septum pellucidum (blue arrows) is present. The temporal horns of the lateral ventricles (yellow arrows) the third ventricle ( # ) and the superior aqueduct of Sylvius (AS) are also markedly dilated, whereas the 4th ventricle is small (green arrow). 

Case Discussion

This case demonstrates the typical features of non-communicating hydrocephalus due to obstruction at the level of the aqueduct of Sylvius. 

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