Disproportionately large communicating fourth ventricle : 後頭蓋窩術後に起こった2症例

概要

論文の詳細を見る
An isolated fourth ventricle or "disproportionately large communicating fourth ventricle" (DLCFV) is a clinical entity characterized by marked dilatation of the fourth ventricle isolated from other cerebrospinal fluid pathways, producing various brain stem and/or cerebellar symptoms. In some cases, the aqueduct is reported patent. Two patients with a DLCFV developed after suboccipital craniectomy are feported. Both cases had previously undergone a ventriculo-peritoneal shunting procedure (V-P shunt) for hydrocephalus secondary to suboccipital craniectomy. Following the malfunction of the V-P shunt, the entire ventricular system was found to be markedly dilated, the fourth ventricle being disproportionately large. The aqueduct was found to be patent. Both cases have had several revisions of the V-P shunt, but they failed to reduce the size of the fourth ventricle and worsened neurological symptoms. Therefore, a fourth ventriculo-peritoneal shunt (IVth-P shunt) was performed. At the time of shunting in one case, pressure monitoring of the fourth ventricle was performed, and revealed large compliance. It is speculated that one of the mechanisms producing the DLCFV is altered cerebellar compliance due to suboccipital craniectomy. IVth-P shunt is proposed as treatment of DLCFV, if it is not relieved by revision of the V-p shunt.
日本脳神経外科学会の論文
1987-06-15