Abstract
Twenty-seven cases of hydrocephalus associated with aqueduct stenosis are reviewed, and a further nine cases discussed in which hydrocephalus was present and the aqueduct was stenosed but some additional feature was present. This was either a meningocoele or an encephalocoele, or else the aqueduct was not completely obstructed radiologically at the initial examination. The ratio of the peripheral measurement from the inion to the nasion to the distance between the inion and the posterior lip of the foramen magnum is presented for each case with an outline of the ventricles. The cases behave as would be expected if the aqueduct was being blocked by the lateral compression of the mid-brain between the enlarged lateral ventricles. On reviewing these cases and other evidence it is suggested that non-tumourous aqueduct stenosis is more likely to be the result of hydrocephalus than the initial cause. The response to treatment is reviewed and a high relapse rate noted. It is suggested that assessment of the extracerebral pathways may be advisable before undertaking third ventriculostomy or ventriculo-cisternostomy.
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Selected References
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- BECKETT R. S., NETSKY M. G., ZIMMERMAN H. M. Developmental stenosis of the aqueduct of Sylvius. Am J Pathol. 1950 Sep;26(5):755–787. [PMC free article] [PubMed] [Google Scholar]
- Borit A., Sidman R. L. New mutant mouse with communicating hydrocephalus and secondary aqueductal stenosis. Acta Neuropathol. 1972;21(4):316–331. doi: 10.1007/BF00685139. [DOI] [PubMed] [Google Scholar]
- Crosby R. M., Henderson C. M., Paul R. L. Catheterization of the cerebral aqueduct for obstructive hydrocephalus in infants. J Neurosurg. 1973 May;38(5):596–601. doi: 10.3171/jns.1973.38.5.0596. [DOI] [PubMed] [Google Scholar]
- Elvidge A. R. Treatment of obstructive lesions of the aqueduct of Sylvius and the fourth ventricle by interventriculostomy. J Neurosurg. 1966 Jan;24(1):11–23. doi: 10.3171/jns.1966.24.1.0011. [DOI] [PubMed] [Google Scholar]
- Emery J. L. Deformity of the aqueduct of sylvius in children with hydrocephalus and myelomeningocele. Dev Med Child Neurol. 1974 Dec;16(6 Suppl 32):40–48. doi: 10.1111/j.1469-8749.1974.tb03448.x. [DOI] [PubMed] [Google Scholar]
- FORD R., SPATZ E. L. Post-traumatic obstruction of the aqueduct of Sylvius and postdecompression cerebral edema treated by ventriculostomy. N Engl J Med. 1960 Aug 11;263:263–267. doi: 10.1056/NEJM196008112630601. [DOI] [PubMed] [Google Scholar]
- Foltz E. L., Shurtleff D. B. Conversion of communicating hydrocephalus to stenosis or occlusion of the aqueduct during ventricular shunt. J Neurosurg. 1966 Feb;24(2):520–529. doi: 10.3171/jns.1966.24.2.0520. [DOI] [PubMed] [Google Scholar]
- GREENWOOD J., Jr, HICKEY W. C. Cerebral aqueduct stenosis; treatment by aqueduct-cisternal shunt. Dis Nerv Syst. 1956 Sep;17(9):277–279. [PubMed] [Google Scholar]
- Harrison M. J., Robert C. M., Uttley D. Benign aqueduct stenosis in adults. J Neurol Neurosurg Psychiatry. 1974 Dec;37(12):1322–1328. doi: 10.1136/jnnp.37.12.1322. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jansen J. Sex-linked hydrocephalus. Dev Med Child Neurol. 1975 Oct;17(5):633–640. doi: 10.1111/j.1469-8749.1975.tb03532.x. [DOI] [PubMed] [Google Scholar]
- Johnson R. T., Johnson K. P. Hydrocephalus following viral infection: the pathology of aqueductal stenosis developing after experimental mumps virus infection. J Neuropathol Exp Neurol. 1968 Oct;27(4):591–606. [PubMed] [Google Scholar]
- Johnson R. T. Mumps virus encephalitis in the hamster. Studies of the inflammatory response and noncytopathic infection of neurons. J Neuropathol Exp Neurol. 1968 Jan;27(1):80–95. doi: 10.1097/00005072-196801000-00005. [DOI] [PubMed] [Google Scholar]
- Kesterson J. W., Carlton W. W. Histopathologic and enzyme histochemical observations of the cuprizone-induced brain edema. Exp Mol Pathol. 1971 Aug;15(1):82–96. doi: 10.1016/0014-4800(71)90020-7. [DOI] [PubMed] [Google Scholar]
- Little J. R., Houser O. W., MacCarty C. S. Clinical manifestations of aqueductal stenosis in adults. J Neurosurg. 1975 Nov;43(5):546–552. doi: 10.3171/jns.1975.43.5.0546. [DOI] [PubMed] [Google Scholar]
- MACFARLANE A., MALONEY A. F. The appearance of the aqueduct and its relationship to hydrocephalus in the Arnold-Chiari malformation. Brain. 1957 Dec;80(4):479–491. doi: 10.1093/brain/80.4.479. [DOI] [PubMed] [Google Scholar]
- Masters C., Alpers M., Kakulas B. Pathogenesis of reovirus type 1 hydrocephalus in mice. Significance of aqueductal changes. Arch Neurol. 1977 Jan;34(1):18–28. doi: 10.1001/archneur.1977.00500130038008. [DOI] [PubMed] [Google Scholar]
- Nag T. K., Falconer M. A. Non-tumoral stenosis of the aqueduct in adults. Br Med J. 1966 Nov 12;2(5523):1168–1170. doi: 10.1136/bmj.2.5523.1168. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Noetzel H. Stenosis or atresia of the aqueduct of Sylvius as a cause of congenital hydrocephalus. Dev Med Child Neurol Suppl. 1970;22(Suppl):123+–123+. doi: 10.1111/j.1469-8749.1970.tb03015.x. [DOI] [PubMed] [Google Scholar]
- PAINE K. W., McKISSOCK W. Aqueduct stenosis; clinical aspects, and results of treatment by ventriculocisternostomy (Torkildsen's operation). J Neurosurg. 1955 Mar;12(2):127–145. doi: 10.3171/jns.1955.12.2.0127. [DOI] [PubMed] [Google Scholar]
- Patterson R. H., Jr, Bergland R. M. The selection of patients for third ventriculostomy bases on experience with 33 operations. J Neurosurg. 1968 Sep;29(3):252–254. doi: 10.3171/jns.1968.29.3.0252. [DOI] [PubMed] [Google Scholar]
- SCARFF J. E. Treatment of hydrocephalus: an historical and critical review of methods and results. J Neurol Neurosurg Psychiatry. 1963 Feb;26:1–26. doi: 10.1136/jnnp.26.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Schechter M. M., Zingesser L. H. The radiology of aqueductal stenosis. Radiology. 1967 May;88(5):905–916. doi: 10.1148/88.5.905. [DOI] [PubMed] [Google Scholar]
- TORKILDSEN A. A follow-up study 14 to 20 years after ventriculocisternostomy. Acta Psychiatr Scand. 1960;35:113–121. doi: 10.1111/j.1600-0447.1960.tb07596.x. [DOI] [PubMed] [Google Scholar]
- WOOLLAM D. H. M., MILLEN J. W. Anatomical considerations in the pathology of stenosis of the cerebral aqueduct. Brain. 1953 Mar;76(1):104–112. doi: 10.1093/brain/76.1.104. [DOI] [PubMed] [Google Scholar]
- Williams B. Cerebrospinal fluid pressure-gradients in spina bifida cystica, with special reference to the Arnold-Chiari malformation and aqueductal stenosis. Dev Med Child Neurol Suppl. 1975;(35):138–150. doi: 10.1111/j.1469-8749.1975.tb03594.x. [DOI] [PubMed] [Google Scholar]
- Williams B., Guthkelch A. N. Why do central arachnoid pouches expand? J Neurol Neurosurg Psychiatry. 1974 Oct;37(10):1085–1092. doi: 10.1136/jnnp.37.10.1085. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Williams B. Is aqueduct stenosis a result of hydrocephalus? Brain. 1973 Jun;96(2):399–412. doi: 10.1093/brain/96.2.399. [DOI] [PubMed] [Google Scholar]