Hydrocephalus Caused by Primary Fourth Ventricle Outlet Obstruction: Our Experience and Literature Review
Language English Country United States Media print-electronic
Document type Journal Article, Review
PubMed
33444837
DOI
10.1016/j.wneu.2021.01.008
PII: S1878-8750(21)00027-9
Knihovny.cz E-resources
- Keywords
- Endoscopic third ventriculostomy, Fourth ventricular outlet obstruction, Hydrocephalus, Luschka foramen, Magendie foramen, Neuroendoscopy,
- MeSH
- Fourth Ventricle * diagnostic imaging surgery MeSH
- Diplopia etiology MeSH
- Child MeSH
- Adult MeSH
- Endoscopy MeSH
- Hydrocephalus diagnostic imaging epidemiology etiology surgery MeSH
- Intracranial Hypertension etiology MeSH
- Infant MeSH
- Craniotomy MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Gait Disorders, Neurologic etiology MeSH
- Infant, Newborn MeSH
- Consciousness Disorders etiology MeSH
- Child, Preschool MeSH
- Retrospective Studies MeSH
- Aged MeSH
- Cerebrospinal Fluid Shunts MeSH
- Ventriculostomy MeSH
- Treatment Outcome MeSH
- Vomiting etiology MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Infant MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Infant, Newborn MeSH
- Child, Preschool MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
OBJECTIVE: Primary fourth ventricle outlet obstruction (PFVOO) is a rare cause of hydrocephalus with an unclear etiopathogenesis, and thus, consensus regarding the recommended treatment protocol is lacking. This study aims to summarize current knowledge of this condition in the light of our own treatment experience. METHODS: Retrospective analysis was carried out of all patients treated for noncommunicating tetraventricular hydrocephalus between 2006 and 2019, from which a subgroup of patients with PFVOO was created. A literature review of PFVOO cases was also carried out. RESULTS: A total of 62 patients with PFVOO were discovered, of whom 8 were treated at our institution, representing 3.8% of our patients with noncommunicating hydrocephalus. Patients most commonly presented with headaches, gait disturbance, or symptoms of intracranial hypertension. The mean follow-up duration was 75.4 months among our patients and 29.9 months in the literature. Most patients (54.8%) were treated by endoscopic third ventriculostomy (ETV), with the remainder undergoing suboccipital craniotomy alone (17.7%) or in combination with shunt surgery (9.7%), or endoscopic magendieplasty (12.9%). Treatment failure was noted in 28.6% of ETVs and 9% of craniotomies. No failures were recorded after endoscopic magendieplasty. The risk of treatment failure was found to be significantly higher with ETV compared with other treatment modalities (P < 0.0005). CONCLUSIONS: Despite the fact that PFVOO can be defined as an obstructive hydrocephalus, there seems to be a higher risk of ETV failure in such cases. The alternative treatment modalities presented are still recommended. Confirmation of these findings requires a larger multicenter study.
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