Primary Occlusion of the Fourth Ventricle: Case Report and Review of the Literature
Idiopathic obstruction of the outlets of the fourth ventricle (FVOO) is a rare cause of hydrocephalus, which can be misdiagnosed as communicating hydrocephalus due to the enlargement of all four ventricles. Different surgical approaches are discussed in the literature. We present a case report of a...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Surgeries |
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| Online Access: | https://www.mdpi.com/2673-4095/4/4/63 |
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| author | Eike Wilbers Samer Zawy Alsofy Stephanie Schipmann Christian Ewelt Thomas Fortmann Marc Lewitz Michael Schwake |
| author_facet | Eike Wilbers Samer Zawy Alsofy Stephanie Schipmann Christian Ewelt Thomas Fortmann Marc Lewitz Michael Schwake |
| author_sort | Eike Wilbers |
| collection | DOAJ |
| description | Idiopathic obstruction of the outlets of the fourth ventricle (FVOO) is a rare cause of hydrocephalus, which can be misdiagnosed as communicating hydrocephalus due to the enlargement of all four ventricles. Different surgical approaches are discussed in the literature. We present a case report of a 25-year-old male admitted with headache, vertigo, and nystagmus. The MRI scan showed a tetraventricular hydrocephalus with a patent aqueduct. After endoscopic third ventriculostomy (ETV), symptoms resolved. We performed a systematic review of the literature, covering 26 years, with the aim to investigate the symptoms, therapy, and outcome of primary FVOO, according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We found 9 case reports and 2 case series and could extract a total of 34 cases. After ETV all symptoms resolved in 10 of 23 cases (43.5%), and in 13 of 23 cases (56.5%) symptoms improved partially. Seven cases (30.4%) required additional surgery. A decrease in ventricular volume occurred in most cases. In the 10 patients who were operated via fenestration, all symptoms resolved in 6 cases. ETV seems to be an effective treatment option for patients with idiopathic FVOO in a majority of cases. In special cases, fenestration of the foramen of Magendie may be suitable. |
| first_indexed | 2024-03-08T20:20:42Z |
| format | Article |
| id | doaj.art-12eb43a90ec04f13bb8e3784a62982c2 |
| institution | Directory Open Access Journal |
| issn | 2673-4095 |
| language | English |
| last_indexed | 2024-03-08T20:20:42Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Surgeries |
| spelling | doaj.art-12eb43a90ec04f13bb8e3784a62982c22023-12-22T14:43:31ZengMDPI AGSurgeries2673-40952023-12-014466567710.3390/surgeries4040063Primary Occlusion of the Fourth Ventricle: Case Report and Review of the LiteratureEike Wilbers0Samer Zawy Alsofy1Stephanie Schipmann2Christian Ewelt3Thomas Fortmann4Marc Lewitz5Michael Schwake6Department of Neurosurgery, University Hospital Münster, 48149 Münster, GermanyDepartment of Neurosurgery, St. Barbara-Hospital, Academic Hospital of University Münster, 59073 Hamm, GermanyDepartment of Neurosurgery, University Hospital Münster, 48149 Münster, GermanyDepartment of Neurosurgery, University Hospital Münster, 48149 Münster, GermanyDepartment of Neurosurgery, St. Barbara-Hospital, Academic Hospital of University Münster, 59073 Hamm, GermanyDepartment of Neurosurgery, St. Barbara-Hospital, Academic Hospital of University Münster, 59073 Hamm, GermanyDepartment of Neurosurgery, University Hospital Münster, 48149 Münster, GermanyIdiopathic obstruction of the outlets of the fourth ventricle (FVOO) is a rare cause of hydrocephalus, which can be misdiagnosed as communicating hydrocephalus due to the enlargement of all four ventricles. Different surgical approaches are discussed in the literature. We present a case report of a 25-year-old male admitted with headache, vertigo, and nystagmus. The MRI scan showed a tetraventricular hydrocephalus with a patent aqueduct. After endoscopic third ventriculostomy (ETV), symptoms resolved. We performed a systematic review of the literature, covering 26 years, with the aim to investigate the symptoms, therapy, and outcome of primary FVOO, according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We found 9 case reports and 2 case series and could extract a total of 34 cases. After ETV all symptoms resolved in 10 of 23 cases (43.5%), and in 13 of 23 cases (56.5%) symptoms improved partially. Seven cases (30.4%) required additional surgery. A decrease in ventricular volume occurred in most cases. In the 10 patients who were operated via fenestration, all symptoms resolved in 6 cases. ETV seems to be an effective treatment option for patients with idiopathic FVOO in a majority of cases. In special cases, fenestration of the foramen of Magendie may be suitable.https://www.mdpi.com/2673-4095/4/4/63endoscopic approacheshydrocephalusprimary fourth ventricle outlet obstructionthird ventriculostomy |
| spellingShingle | Eike Wilbers Samer Zawy Alsofy Stephanie Schipmann Christian Ewelt Thomas Fortmann Marc Lewitz Michael Schwake Primary Occlusion of the Fourth Ventricle: Case Report and Review of the Literature Surgeries endoscopic approaches hydrocephalus primary fourth ventricle outlet obstruction third ventriculostomy |
| title | Primary Occlusion of the Fourth Ventricle: Case Report and Review of the Literature |
| title_full | Primary Occlusion of the Fourth Ventricle: Case Report and Review of the Literature |
| title_fullStr | Primary Occlusion of the Fourth Ventricle: Case Report and Review of the Literature |
| title_full_unstemmed | Primary Occlusion of the Fourth Ventricle: Case Report and Review of the Literature |
| title_short | Primary Occlusion of the Fourth Ventricle: Case Report and Review of the Literature |
| title_sort | primary occlusion of the fourth ventricle case report and review of the literature |
| topic | endoscopic approaches hydrocephalus primary fourth ventricle outlet obstruction third ventriculostomy |
| url | https://www.mdpi.com/2673-4095/4/4/63 |
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