scholarly journals Spontaneous resolution of obstructive hydrocephalus from blood in the cerebral aqueduct

2011 ◽  
Vol 1 (1) ◽  
pp. 15 ◽  
Author(s):  
Shadi Yaghi ◽  
Archana Hinduja
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Clinical Improvement ◽  
Fourth Ventricle ◽  
Obstructive Hydrocephalus ◽  
Spontaneous Resolution ◽  
Cerebral Aqueduct ◽  
Neurological Emergency ◽  
Head Computed Tomography

Obstructive hydrocephalus is a neurological emergency that needs to be immediately identified and treated. It very rarely resolves without treatment. We report about an 86-year-old man with right frontal stroke who developed obstructive hydrocephalus caused by blood in the cerebral aqueduct. The patient had sudden and immediate clinical improvement and a repeated head computed tomography (CT) scan showing spontaneous resolution of hydrocephalus. Spontaneous resolution of obstructive hydrocephalus is possible when the cause is minimal blood in the cerebral aqueduct without any blood in the fourth ventricle.

Hemangioma Calcificans in the Fourth Ventricle

Neurosurgery ◽  
1984 ◽  
Vol 14 (6) ◽  
pp. 737-739 ◽  
Author(s):  
Kobayashi Hidenori ◽  
Kawano Hirokazu ◽  
Ito Haruhide ◽  
Hayashi Minoru ◽  
Yamamoto Shinjiro
Keyword(s):  
Computed Tomography ◽  
Intracranial Pressure ◽  
Posterior Fossa ◽  
Clinical Picture ◽  
Fourth Ventricle ◽  
Obstructive Hydrocephalus ◽  
Increased Intracranial Pressure ◽  
X Ray ◽  
4Th Ventricle

Abstract A case of hemangioma calcificans in the 4th ventricle is reported. Skull x-ray films demonstrated a dense calcification in the posterior fossa. Computed tomography disclosed a hyperdense mass in the 4th ventricle. The clinical picture was of increased intracranial pressure due to obstructive hydrocephalus. An hemangioma calcificans in the 4th ventricle was removed successfully.

scholarly journals Partially Sequestered Fourth Ventricle: CT and MR Diagnosis of an Unusual Entity

1989 ◽  
Vol 16 (1) ◽  
pp. 84-87 ◽  
Author(s):  
V.G. Wagle ◽  
D. Melanson ◽  
J.G. Villemure
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Fourth Ventricle ◽  
Water Soluble ◽  
Communicating Hydrocephalus ◽  
Direct Visualization ◽  
Aqueduct Of Sylvius

ABSTRACT:Encystment of the fourth ventricle, due to occlusion of the aqueduct as well as the foramina of Magendie and Luschka has been described previously. Partial sequestration such as that encountered in two cases described is a less common entity. In these two cases, the aqueduct of Sylvius was occluded, but the basal foramina (Magendie and Luschka) were patent. We discuss this partial sequestration or communicating hydrocephalus of the fourth ventricle on the basis of MR and CT scan findings. Although computed tomography following water soluble cisternography did diagnose the entity indirectly MRI proved to be a superior tool. It permitted direct visualization of the basal foramina noninvasively.

Utility of multislice computed tomography and reformatted images: identification of migratory intraventricular clot exacerbating obstructive hydrocephalus

2008 ◽  
Vol 109 (1) ◽  
pp. 156-158 ◽  
Author(s):  
Rihan Khan ◽  
Alexander C. Mamourian ◽  
Tarek Radwan
Keyword(s):  
Computed Tomography ◽  
Multislice Computed Tomography ◽  
Multidetector Ct ◽  
Obstructive Hydrocephalus ◽  
Axial Plane ◽  
Cerebral Aqueduct

Multidetector CT has become widely available and with it the ability to rapidly create detailed reformatted images. Multiplanar images can be created depicting the anatomy in planes other than the traditional axial plane, using isotropic to near-isotropic data. It is important for both clinicians and radiologists to be aware of this capability in order to take advantage of such images. To illustrate the value of this type of imaging, the authors present a case of a third ventricular clot that migrated into the cerebral aqueduct exacerbating hydrocephalus.

Where the central canal begins: endoscopic in vivo description

2021 ◽  
pp. 1-10
Author(s):  
Pierluigi Longatti ◽  
Alessandro Fiorindi ◽  
Elisabetta Marton ◽  
Francesco Sala ◽  
Alberto Feletti
Keyword(s):  
Fourth Ventricle ◽  
Area Postrema ◽  
Obstructive Hydrocephalus ◽  
Indirect Evidence ◽  
Normal Pressure ◽  
Central Canal ◽  
Pathological Process ◽  
Cerebral Aqueduct ◽  
Anatomical Landmarks

OBJECTIVE Although evidence and descriptions of the central canal (CC) along the medulla oblongata and the spinal cord have been provided by several anatomical and radiological studies, a clear picture and assessment of the opening of the CC, or apertura canalis centralis (ACC), into the fourth ventricle is lacking, due to its submillimetric size and hidden position in the calamus scriptorius. METHODS The authors reviewed all of their cases in which patients underwent ventricular transaqueductal flexible endoscopic procedures and selected 44 cases in which an inspection of the region of the calamus scriptorius had been performed and was suitable for study inclusion. Patients were divided into different groups, based on the presence or absence of a chronic pathological process involving the fourth ventricle. In each case, the visual appearance of the opening of the CC of the ACC was classified as no evidence (A0), indirect evidence (A1), or clear evidence (A2). Morphometric measurements were inferred from surrounding structures and the size of surgical tools visible in the field. RESULTS The opening of the CC could be clearly observed in all cases (A1 4.5%, A2 95.5%). In normal cases, a lanceolate shape along the median sulcus was most frequently found, with an average size of 600 × 250 µm that became rounded and smaller in size in cases of hydrocephalus. The distance between the caudal margin of the ACC and the obex was about 1.8 mm in normal cases, 2.1 mm in cases of obstructive hydrocephalus, and 1 mm in cases of normal pressure hydrocephalus. The two wings of the area postrema, variable in size and shape, were sited just caudal to the opening. CONCLUSIONS A flexible scope inserted through the cerebral aqueduct can approach the hidden calamus scriptorius like a pen fits into an inkpot. With this privileged viewpoint, the authors provide for the first time, to their knowledge, a clear and novel vision of the opening of the CC in the fourth ventricle, along with the precise location of this tiny structure compared to other anatomical landmarks in the inferior triangle.

scholarly journals Clinical predictors of abnormal head computed tomography scan in patients who are conscious after head injury

2017 ◽  
Vol 08 (01) ◽  
pp. 064-067 ◽  
Author(s):  
Rakesh Kumar Mishra ◽  
Ashok Munivenkatappa ◽  
Vasuki Prathyusha ◽  
Dhaval P. Shukla ◽  
Bhagavatula Indira Devi
Keyword(s):  
Computed Tomography ◽  
Head Injury ◽  
Ct Scan ◽  
Clinical Features ◽  
Significant Risk ◽  
Observation Study ◽  
Head Ct ◽  
Abnormal Head ◽  
History Of ◽  
Head Computed Tomography

ABSTRACT Background: Indication of a head computed tomography (CT) scan in a patient who remains conscious after head injury is controversial. We aimed to determine the clinical features that are most likely to be associated with abnormal CT scan in patients with a history of head injury, and who are conscious at the time of presentation to casualty. Materials and Methods: This is a prospective observation study of patients presented to casualty with history of head injury, and who were conscious, i.e., Glasgow Coma Scale (GCS) 15 at the time of evaluation. All patients underwent head CT scan. The CT scan was reported as abnormal if it showed any pathology ascribed to trauma. The following variables were used: age, gender, mode of injury (road traffic accident, fall, assault, and others), duration since injury, and history of transient loss of consciousness, headache, vomiting, ear/nose bleeding, and seizures. Logistic regression analysis was used to identify the clinical features that predicted an abnormal CT scan. Results: During the observation period, a total of 1629 patients with head injury were evaluated, out of which 453 were in GCS 15. Abnormal CT scan was present in 195 (43%) patients. Among all the variables, the following were found significantly associated with abnormal CT scan: duration since injury (>12 h) P < 0.001; vomiting odds, ratio (OR) 1.89 (1.23, 2.80), P < 0.001; and presence of any symptom, OR 2.36 (1.52, 3.71), P < 0.001. Conclusion: A patient with GCS 15 presenting after 12 hours of injury with vomiting or combination of symptoms has a significant risk of abnormal head CT scan.

Repeat Head Computed Tomography in Anticoagulated Traumatic Brain Injury Patients: Still Warranted

2014 ◽  
Vol 80 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Bellal Joseph ◽  
Moutamn Sadoun ◽  
Hassan Aziz ◽  
Andrew Tang ◽  
Julie L. Wynne ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Ct Scan ◽  
Intracranial Hemorrhage ◽  
Injury Severity ◽  
Head Ct ◽  
Lengths Of Stay ◽  
Anticoagulation Agents ◽  
Head Computed Tomography

Anticoagulation agents are proven risk factors for intracranial hemorrhage (ICH) in traumatic brain injury (TBI). The aim of our study is to describe the epidemiology of prehospital coumadin, aspirin, and Plavix (CAP) patients with ICH and evaluate the use of repeat head computed tomography (CT) in this group. We performed a retrospective study from our trauma registry. All patients with intracranial hemorrhage on initial CT with prehospital CAP therapy were included. Demographics, CT scan findings, number of repeat CT scans, progressive findings, and neuro-surgical intervention were abstracted. A comparison between prehospital CAP and no-CAP patients was done using χ2 and Mann-Whitney U test. A total of 1606 patients with blunt TBI charts were reviewed of whom 508 patients had intracranial bleeding on initial CT scan and 72 were on prehospital CAP therapy. CAP patients were older ( P < 0.001), had higher Injury Severity Score and head Abbreviated Injury Scores on admission ( P < 0.001), were more likely to present with an abnormal neurologic examination ( P = 0.004), and had higher hospital and intensive care unit lengths of stay ( P < 0.005). Eighty-four per cent of patients were on antiplatelet therapy and 27 per cent were on warfarin. The CAP patients have a threefold increase in the rate of worsening repeat head CT (26 vs 9%, P < 0.05). Prehospital CAP therapy is high risk for progression of bleeding on repeat head CT. Routine repeat head CT remains an important component in this patient population and can provide useful information.

The efficacy of routine head computed tomography (CT scan) prior to lumbar puncture in the emergency department

1994 ◽  
Vol 12 (5) ◽  
pp. 597-601 ◽  
Author(s):  
Nancy D. Baker ◽  
Hadi Kharazi ◽  
Lisa Laurent ◽  
Andrew T. Walker ◽  
Daniel S. Williamson ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Ct Scan ◽  
Lumbar Puncture ◽  
Head Computed Tomography

Acute obstructive hydrocephalus caused by a migrating intraventricular calculus

1993 ◽  
Vol 78 (5) ◽  
pp. 826-828 ◽  
Author(s):  
En-Chow Tan ◽  
Takuji Takagi ◽  
Seiji Matsuura ◽  
Shiro Mizuno
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Lateral Ventricle ◽  
Fourth Ventricle ◽  
Obstructive Hydrocephalus ◽  
Third Ventricle ◽  
Cerebral Aqueduct ◽  
Ventricular Drainage ◽  
Content Type ◽  
The Third ◽  
Fine Print

✓ A 10-year-old boy presented with acute obstructive hydrocephalus caused by the impaction of a calculus on the cerebral aqueduct. The calculus migrated from the third ventricle to the fourth ventricle after ventricular drainage and right ventriculoperitoneal shunt placement had been performed. The nature and origin of the calculus could not be determined, although its release from the choroid plexus in the lateral ventricle is highly possible.

Feed and Swaddle: An Alternative to Infant Sedation for Craniofacial Imaging

2019 ◽  
Vol 56 (10) ◽  
pp. 1373-1376
Author(s):  
Nick Esmonde ◽  
Breanna Jedrzejewski ◽  
Beth Fitzpatrick ◽  
Jeffrey Koh ◽  
Dianna Bardo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Surgical Planning ◽  
Medical Center ◽  
Academic Medical Center ◽  
Diagnostic Quality ◽  
Academic Medical ◽  
Successful Group ◽  
Developmental Risks ◽  
Head Computed Tomography

Objective: The gold standard for diagnosis of craniosynostosis is a clinical examination and motionless head computed tomography (CT). Computed tomography sedation is associated with increased cost, resource utilization, medical, and possible developmental risks. This study investigates whether a “feed and swaddle” protocol can be used to achieve diagnostic quality craniofacial imaging without the use of infant sedation. Design: Prospective cohort study. Setting: Tertiary academic medical center. Patients: Ninety patients <18 months of age undergoing evaluation for craniosynostosis from 2012 to 2018. Interventions: A feed and swaddle protocol. Main Outcome Measures: Diagnostic level imaging without the use of infant sedation. Results: Eighty-five (94%) achieved a diagnostic quality craniofacial CT scan using the “feed and swaddle” method. Mean patient age was 24.0 ± 10.0 weeks. Craniosynostosis was diagnosed in 74% of patients. Mean age of patients with successful completion of a CT scan was 23.7 ± 9.6 weeks, compared to 27.2 ± 17.1 weeks for unsuccessful completion. Mean weight for the successful group was 15.6 ± 2.9 pounds and 15.9 ± 2.5 pounds for the unsuccessful group. Mean travel distance was 59.2 ± 66.5 miles for successful patients and 66.5 ± 61.5 miles for unsuccessful patients. For the unsuccessful patients, there were no delays in surgical planning or scheduling. Conclusion: The “feed and swaddle” protocol described here is an effective alternative to infant sedation for motionless craniofacial CT imaging.

Endoscopic-Assisted Median Aperture Approach for Resection of Fourth Ventricular Tumor and Confirmation of Patency of Cerebral Aqueduct Using an Adjustable-Angle Endoscope: Technical Case Report

2017 ◽  
Vol 13 (2) ◽  
pp. 293-296 ◽  
Author(s):  
Ryan Austerman ◽  
Joshua Lucas ◽  
Alexandra Kammen ◽  
Gabriel Zada
Keyword(s):  
Case Report ◽  
Fourth Ventricle ◽  
Obstructive Hydrocephalus ◽  
Tumor Resection ◽  
Technical Note ◽  
Cerebral Aqueduct ◽  
Suboccipital Craniotomy ◽  
Cerebellar Retraction ◽  
Telovelar Approach ◽  
Operative Microscope

Abstract BACKGROUND AND IMPORTANCE: Open microsurgical approaches to the roof of the fourth ventricle via a telovelar approach typically require cerebellar retraction and/or splitting of the vermis and may be associated with postoperative neurological morbidities. In this case report and technical note, we describe the use of an adjustable-angle endoscope inserted into the median aperture via suboccipital craniotomy, resulting in enhanced visualization of the roof of the fourth ventricle and cerebral aqueduct and maximal safe tumor resection. CLINICAL PRESENTATION: A 49-yr-old woman with obstructive hydrocephalus and a fourth ventricular mass that was not fully visible with the use of an operative microscope. CONCLUSION: Direct visualization of the roof of the fourth ventricle, including the superior medullary velum and cerebral aqueduct, can be facilitated with an adjustable angle endoscope inserted into the median aperture via suboccipital craniotomy to minimize the degree of telovelar dissection and vermis splitting.

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