Aqueduct stenosis (web)

Case contributed by A.Prof Frank Gaillard

Presentation

Fall and ventriculomegaly found.

Patient Data

Age: 55
Gender: Male
CT

Hydrocephalus involving the lateral ventricles, and third ventricles. The aqueduct appears enlarged. The fourth ventricle is normal in size. 

MRI

The lateral and third ventricles are dilated. The temporal horns are dilated and the floor of the third ventricle is bowed inferiorly, both suggesting that the ventricular enlargement is due to an obstructive hydrocephalus The basal cisterns are capacious. However, the aqueduct is markedly dilated throughout its length and appears focally stenosed at its termination at its junction with the fourth ventricle. Flow studies suggests little / no cerebrospinal fluid flow passing through the aqueduct and T2-weighted scans show no evidence of pulsatility within the third and fourth ventricles, normally expected in communicating hydrocephalus. Corpus callosum is stretched and thinned, but no evidence of interstitial ( transependymal ) oedema. Cortical sulci moderately flattened.

Conclusion:

Moderate, probably compensated hydrocephalus due to aqueduct stenosis (web).

CT

Shunt was inserted with marked reduction in ventricular size. 

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Case information

rID: 29319
Case created: 16th May 2014
Last edited: 28th Oct 2015
Inclusion in quiz mode: Included

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