Author/Authors :
Tine, Ibrahima Unit of Neurosurgery - Principal Hospital of Dakar, Dakar, Senegal, West Africa , Diop, Abdou A Unit of Neurosurgery - Principal Hospital of Dakar, Dakar, Senegal, West Africa , Mbengue, Ababacar Department of Imaging - Principal Hospital of Dakar, Dakar, Senegal, West Africa , Wimenga, Abdou K Department of Neurosurgery - University Hospital Center of Fann, Dakar, Senegal, West Africa , Mudekereza, Paterne S Department of Neurosurgery - University Hospital Center of Fann, Dakar, Senegal, West Africa , Badiane, Seydou B Department of Neurosurgery - University Hospital Center of Fann, Dakar, Senegal, West Africa
Abstract :
Background & Importance: Idiopathic stenosis of the foramina of Magendie and Luschka is a rare cause of obstructive
hydrocephalus involving the fourth ventricle.
Case Presentation: We reported the case of a 40-year-old woman who developed headaches and vertigo for several months
and more recently gait disturbance. The CT scan showed quadri-ventricular hydrocephalus involving mainly the fourth
ventricle with dilated lateral recesses. Craniocervical MRI confirmed hydrocephalus and also showed the brainstem and
cerebellar tonsil herniation through the foramen magnum with hydromyelia and a hyperintense signal on T2 weighted
MRI of cervical spinal cord. Biological analyses were normal. She underwent endoscopic third ventriculostomy (ETV).
No complication was observed. The patient became asymptomatic during the weeks following the surgical procedure
and remained stable at a mean follow-up interval of 20 months. Postoperative MR images demonstrated regression of the
hydrocephalus; complete disappearance of brainstem and cerebellar tonsil herniation, hydromylia and the hyperintense
signal on T2 weighted MRI of cervical spinal cord.
Conclusion: This case confirms the existence of hydrocephalus caused by idiopathic fourth ventricle outflows obstruction
in adult and the efficacy of ETV for this rare indication.
