Ahmet Öğrenci1, Murat Şakir Ekşi2, Orkun Koban3. 1. Department of Neurosurgery, Batman State Hospital, Batman, Turkey. 2. Department of Orthopedic Surgery-Spine Center, University of California at San Francisco, 500 Parnassus Avenue MU320 West, San Francisco, CA, 94143-0728, USA. muratsakireksi@gmail.com. 3. Department of Neurosurgery, Kurtköy Ersoy Hospital, Istanbul, Turkey.
Abstract
BACKGROUND: Spontaneous ventriculostomy is spontaneous rupture of membranes separating the ventricular system from the subarachnoid space in patients with chronic obstructive hydrocephalus that ends with resolution of symptoms. We present a case of spontaneous third ventriculostomy occurred in a 19-year-old girl 8 years after the initial diagnosis of hydrocephalus. CASE DESCRIPTION: An 11-year-old girl applied to the clinic with intermittent headaches. She was neurologically stable with no visual problems. On her brain MRI, obstructive hydrocephalus was observed. Cerebrospinal fluid diversion procedures were recommended, yet the family denied any interventional procedure. She had routine follow-ups with occasional clinical admissions because of ongoing intermittent headaches. On her last clinical visit, 8 years after the first one, she was in well condition with improvement in her headache in the last 4 months. Her new brain MRI showed an active CSF flow between the basal cistern and the third ventricle. DISCUSSION AND CONCLUSION: In patients with aqueductal stenosis and without any other mass lesion, wait and see protocol might be conveyed in case of mild symptoms of hydrocephalus. However, there is need for large-scaled studies to make a more comprehensive statement for benign obstructive hydrocephalus cases.
BACKGROUND: Spontaneous ventriculostomy is spontaneous rupture of membranes separating the ventricular system from the subarachnoid space in patients with chronic obstructive hydrocephalus that ends with resolution of symptoms. We present a case of spontaneous third ventriculostomy occurred in a 19-year-old girl 8 years after the initial diagnosis of hydrocephalus. CASE DESCRIPTION: An 11-year-old girl applied to the clinic with intermittent headaches. She was neurologically stable with no visual problems. On her brain MRI, obstructive hydrocephalus was observed. Cerebrospinal fluid diversion procedures were recommended, yet the family denied any interventional procedure. She had routine follow-ups with occasional clinical admissions because of ongoing intermittent headaches. On her last clinical visit, 8 years after the first one, she was in well condition with improvement in her headache in the last 4 months. Her new brain MRI showed an active CSF flow between the basal cistern and the third ventricle. DISCUSSION AND CONCLUSION: In patients with aqueductal stenosis and without any other mass lesion, wait and see protocol might be conveyed in case of mild symptoms of hydrocephalus. However, there is need for large-scaled studies to make a more comprehensive statement for benign obstructive hydrocephalus cases.
Entities:
Keywords:
Headache; Hydrocephalus; Spontaneous third ventriculostomy
Authors: A Rovira; J Capellades; E Grivé; M A Poca; S Pedraza; J Sahuquillo; A Rodríguez-Baeza Journal: AJNR Am J Neuroradiol Date: 1999-10 Impact factor: 3.825