Obstructive hydrocephalus due to aqueduct stenosis with secondary intracranial hypertension

Case contributed by Dr Ammar Haouimi

Presentation

Chronic headaches with bilateral papilledema.

Patient Data

Age: 35 years
Gender: Male

The MRI sequences demonstrate:

  • dilatation of the 3rd and lateral ventricles with mild transependymal edema. The sagittal FIESTA shows aqueduct stenosis (web/diaphragm) with normal size and configuration of the 4th ventricle
  • Signs of secondary intracranial hypertension
    • vertical tortuosity of the optic nerves
    • prominent subarachnoid space around the optic nerves
    • bilateral flattening of the posterior sclera
    • mild enlargement of the Meckel cave

Case Discussion

MRI features of obstructive hydrocephalus due to aqueduct stenosis (web/diaphragm) with secondary intracranial hypertension.

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