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Minim Invasive Neurosurg 2003; 46(1): 57-60
DOI: 10.1055/s-2003-37960
Technical Note
© Georg Thieme Verlag Stuttgart · New York

Stereotactically-Guided Fourth Ventriculo-Peritoneal Shunting for the Isolated Fourth Ventricle

M. E.  Colpan1 , A.  Savas1 , N.  Egemen1 , Y.  Kanpolat1
  • 1Department of Neurosurgery, Ankara University, School of Medicine, Ankara, Turkey
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Publication History

Publication Date:
17 March 2003 (online)

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Zusammenfassung

Abstract

The isolated fourth ventricle (IFV) develops in which obstruction to the out flow of cerebrospinal fluid from the choroid plexus of the fourth ventricle occurs rostrally and caudally. IFV has been a rare occurrence and is difficult to treat. We had an occasion to admit a 28-year-old female to our hospital due to hydrocephalus: she also had a history of meningitis a year ago. The patient was initially managed by a lateral ventriculo-peritoneal shunting procedure. Six months after the procedure the patient began to suffer from vomiting, nausea, and diplopia. CT and MRI scans demonstrated an isolated fourth ventricle enlargement; and thus, a fourth ventriculo-peritoneal shunting procedure was performed under stereotactic conditions. The authors present a case of an isolated fourth ventricle after lateral ventriculo-peritoneal shunting for hydrocephalus, which was treated with a stereotactically guided fourth ventriculo-peritoneal shunting procedure. The technique of this procedure is described below.

Key words

Isolated Fourth Ventricle - Hydrocephalus - Stereotactic Technique - Ventriculo-Peritoneal Shunt

References

  • 1 Kojima N, Tamaki N, Matsumoto S. [Clinical evaluation of an isolated fourth ventricle].  No To Shinkei. 1988;  40(7) 679-687
    PubMedGoogle Scholar
  • 2 James H E. Spectrum of the syndrome of the isolated fourth ventricle in posthemorrhagic hydrocephalus of the premature infant.  Pediatr Neurosurg. 1990;  16(6) 305-308
    PubMedGoogle Scholar
  • 3 Hubbard J L, Houser O W, Laws Jr E R. Trapped fourth ventricle in an adult: radiographic findings and surgical treatment.  Surg Neurol. 1987;  28(4) 301-306
    PubMedGoogle Scholar
  • 4 Hawkins J CD, Hoffman H J, Humphreys R P. Isolated fourth ventricle as a complication of ventricular shunting. Report of three cases.  J Neurosurg. 1978;  49(6) 910-913
    PubMedGoogle Scholar
  • 5 Coker S B, Anderson C L. Occluded fourth ventricle after multiple shunt revisions for hydrocephalus.  Pediatrics. 1989;  83(6) 981-985
    PubMedGoogle Scholar
  • 6 Lee M. et al . Complications of fourth-ventricular shunts.  Pediatr Neurosurg. 1995;  22(6) 309-313
    PubMedGoogle Scholar
  • 7 Hirano T. et al . [A rare case of trapped fourth ventricle: an unique symptom appeared after fourth ventriculo-peritoneal shunting].  No To Shinkei. 1999;  51(3) 247-251
    PubMedGoogle Scholar
  • 8 Da Silva J A. et al . [Isolated fourth ventricle: report of 2 cases].  Arq Neuropsiquiatr. 1998;  56(3B) 621-628
    PubMedGoogle Scholar
  • 9 Aoki N. Communicating fourth ventricular hydrocephalus: case report.  Neurosurgery. 1987;  20(5) 806-808
    PubMedGoogle Scholar
  • 10 Foltz E L. D.D.R., Double Compartment Hydrocephalus - a new clinical entity.  Neurosurgery. 1980;  7 551-559
    PubMedGoogle Scholar
  • 11 Montgomery C T, Winfield J A. Fourth ventricular entrapment caused by rostrocaudal herniation following shunt malfunction.  Pediatr Neurosurg. 1993;  19(4) 209-214
    PubMedGoogle Scholar
  • 12 Foltz E L. S.D., Conversion of communication hydrocephalus to stenosis or occlusion of the aqueduct during ventricular shunt.  J Neurosurg. 1966;  24 520-529
    PubMedGoogle Scholar
  • 13 Zimmerman R A, Bilaniuk L T, Gallo E. Computed tomography of the trapped fourth ventricle.  AJR Am J Roentgenol. 1978;  130(3) 503-506
    PubMedGoogle Scholar
  • 14 Scotti G. et al . The isolated fourth ventricle in children: CT and clinical review of 16 cases.  AJR Am Roentgenol. 1980;  135(6) 1233-1238
    PubMedGoogle Scholar
  • 15 Shose Y, Nogaki H, Kamikawa S. [Disproportionately large, communicating fourth ventricle. Case report].  Neurol Med Chir (Tokyo). 1991;  31(13) 1003-1007
    PubMedGoogle Scholar
  • 16 Matsumoto M. et al . [Disproportionately large communicating fourth ventricle - report of 2 cases].  No Shinkei Geka. 1983;  11(11) 1185-1190
    PubMedGoogle Scholar
  • 17 Hida K, Iwasaki Y, Abe H. [Cystic dilatation of the fourth ventricle - case report].  No To Shinkei. 1991;  43(12) 1169-1173
    PubMedGoogle Scholar
  • 18 Teo C, Burson T, Misra S. Endoscopic treatment of the trapped fourth ventricle [In Process Citation].  Neurosurgery. 1999;  44(6) 1257-1261; discussion 1261 - 1262
    PubMedGoogle Scholar
  • 19 Yeo T T. et al . CT-directed BRW stereotactic neurosurgery: local experience with 42 cases.  Singapore Med J. 1991;  32(5) 307-311
    PubMedGoogle Scholar
  • 20 Asai A. et al . Dandy-Walker syndrome: experience at the Hospital for Sick Children, Toronto.  Pediatr Neurosci. 1989;  15(2) 66-73
    CrossrefPubMedGoogle Scholar
  • 21 Toriyama T. et al . [A case of disproportionately large communicating fourth ventricle (DLCFV) combined with syringomyelia and Chiari malformation].  No Shinkei Geka. 1991;  19(2) 167-172
    PubMedGoogle Scholar
  • 22 Okabe S. et al . [Disproportionately large communicating fourth ventricle with bilateral exotropia: report of two cases].  No Shinkei Geka. 1990;  18(10) 969-973
    PubMedGoogle Scholar
  • 23 Hall T R. et al . Isolation of the fourth ventricle causing transtentorial herniation: neurosonographic findings in premature infants.  AJR Am J Roentgenol. 1992;  159(4) 811-815
    PubMedGoogle Scholar
  • 24 Teo C RS, Boop F A, Cherny B. Complication of endoscopic neurosurgery.  Childs Nerv Syst. 1996;  12 248-253
    PubMedGoogle Scholar
  • 25 Caemaert J AJ. Diagnostic and therapeutic stereotactic cerebral endoscopy.  Acta Neurochir (Wien). 1993;  124 11-13
    CrossrefPubMedGoogle Scholar
  • 26 Kalbarczyk A KJ, Seiler R W. Endoscopic stereotactic surgery for intraventricular loculated empyema: case report.  Surg Neurol. 1999;  52 412-417
    PubMedGoogle Scholar
  • 27 Montes J LCD, Farmer J-P. Stereotactic transtentorial hiatus ventriculoperitonela shunting for sequestered fourth ventricle: Technical note.  J Neurosurg. 1994;  80 759-761
    PubMedGoogle Scholar

Dr. A. Savas

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06693 Ankara

Turkey

Phone: +90-312-4918839 ·

Fax: +90-312-3094340

Email: alisavas63@yahoo.com

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