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Tetraventricular noncommunicating hydrocephalus: Case report and literature review

BACKGROUND: Tetraventricular hydrocephalus is a common presentation of communicating hydrocephalus. Conversely, cases with noncommunicating etiology impose a diagnostic challenge and are often neglected and underdiagnosed. Herein, we present a review of literature for clinical, diagnostic, and surgi...

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Autores principales: Rosa, Magno Rocha Freitas, Cruz, Thainá Zanon, Magalhães Junior, Eduardo Vasconcelos, Nigri, Flavio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific Scholar 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8571210/
https://www.ncbi.nlm.nih.gov/pubmed/34754569
http://dx.doi.org/10.25259/SNI_635_2021
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author Rosa, Magno Rocha Freitas
Cruz, Thainá Zanon
Magalhães Junior, Eduardo Vasconcelos
Nigri, Flavio
author_facet Rosa, Magno Rocha Freitas
Cruz, Thainá Zanon
Magalhães Junior, Eduardo Vasconcelos
Nigri, Flavio
author_sort Rosa, Magno Rocha Freitas
collection PubMed
description BACKGROUND: Tetraventricular hydrocephalus is a common presentation of communicating hydrocephalus. Conversely, cases with noncommunicating etiology impose a diagnostic challenge and are often neglected and underdiagnosed. Herein, we present a review of literature for clinical, diagnostic, and surgical aspects regarding noncommunicating tetrahydrocephalus caused by primary fourth ventricle outlet obstruction (FVOO), illustrating with a case from our service. METHODS: We performed a research on PubMed database crossing the terms “FVOO,” “tetraventriculomegaly,” and “hydrocephalus” in English. Fifteen articles (a total of 34 cases of primary FVOO) matched our criteria and were, therefore, included in this study besides our own case. RESULTS: Most cases presented in adulthood (47%), equally divided between male and female. Clinical presentation was unspecific, commonly including headache, nausea, and dizziness as symptoms (35.29%, 21.57%, and 9.80%, respectively), with ataxic gait (65%) and papilledema (40%) being the most frequent signs. MRI and CT were the imaging modalities of choice (11 patients each), often associated with CSF flow studies, such as cine MRI and CT ventriculogram. Endoscopic third ventriculostomy (ETV) was both the most popular and effective surgical approach (50.85% of cases, with 18.91% of recurrence) followed by ventricle-peritoneal shunt (16.95% of patients, 23.0% of recurrence). CONCLUSION: FVOO stands for a poorly understood etiology of noncommunicating tetrahydrocephalus. With the use of ETV, these cases, once hopeless, had its morbimortality and recurrence reduced greatly. Therefore, its suspicion and differentiation from other forms of tetrahydrocephalus can improve its natural course, reinforcing the importance of its acknowledgment.
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spelling pubmed-85712102021-11-08 Tetraventricular noncommunicating hydrocephalus: Case report and literature review Rosa, Magno Rocha Freitas Cruz, Thainá Zanon Magalhães Junior, Eduardo Vasconcelos Nigri, Flavio Surg Neurol Int Review Article BACKGROUND: Tetraventricular hydrocephalus is a common presentation of communicating hydrocephalus. Conversely, cases with noncommunicating etiology impose a diagnostic challenge and are often neglected and underdiagnosed. Herein, we present a review of literature for clinical, diagnostic, and surgical aspects regarding noncommunicating tetrahydrocephalus caused by primary fourth ventricle outlet obstruction (FVOO), illustrating with a case from our service. METHODS: We performed a research on PubMed database crossing the terms “FVOO,” “tetraventriculomegaly,” and “hydrocephalus” in English. Fifteen articles (a total of 34 cases of primary FVOO) matched our criteria and were, therefore, included in this study besides our own case. RESULTS: Most cases presented in adulthood (47%), equally divided between male and female. Clinical presentation was unspecific, commonly including headache, nausea, and dizziness as symptoms (35.29%, 21.57%, and 9.80%, respectively), with ataxic gait (65%) and papilledema (40%) being the most frequent signs. MRI and CT were the imaging modalities of choice (11 patients each), often associated with CSF flow studies, such as cine MRI and CT ventriculogram. Endoscopic third ventriculostomy (ETV) was both the most popular and effective surgical approach (50.85% of cases, with 18.91% of recurrence) followed by ventricle-peritoneal shunt (16.95% of patients, 23.0% of recurrence). CONCLUSION: FVOO stands for a poorly understood etiology of noncommunicating tetrahydrocephalus. With the use of ETV, these cases, once hopeless, had its morbimortality and recurrence reduced greatly. Therefore, its suspicion and differentiation from other forms of tetrahydrocephalus can improve its natural course, reinforcing the importance of its acknowledgment. Scientific Scholar 2021-10-19 /pmc/articles/PMC8571210/ /pubmed/34754569 http://dx.doi.org/10.25259/SNI_635_2021 Text en Copyright: © 2021 Surgical Neurology International https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Review Article
Rosa, Magno Rocha Freitas
Cruz, Thainá Zanon
Magalhães Junior, Eduardo Vasconcelos
Nigri, Flavio
Tetraventricular noncommunicating hydrocephalus: Case report and literature review
title Tetraventricular noncommunicating hydrocephalus: Case report and literature review
title_full Tetraventricular noncommunicating hydrocephalus: Case report and literature review
title_fullStr Tetraventricular noncommunicating hydrocephalus: Case report and literature review
title_full_unstemmed Tetraventricular noncommunicating hydrocephalus: Case report and literature review
title_short Tetraventricular noncommunicating hydrocephalus: Case report and literature review
title_sort tetraventricular noncommunicating hydrocephalus: case report and literature review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8571210/
https://www.ncbi.nlm.nih.gov/pubmed/34754569
http://dx.doi.org/10.25259/SNI_635_2021
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