Progressive Hydrocephalus after Endoscopic Third Ventriculostomy in Pediatric Patients with Blake's Pouch Cyst

NMC Case Report Journal
Youhei TakeuchiTeiji Tominaga

Abstract

The pathophysiology and optimal treatment for hydrocephalus with Blake's pouch cyst (BPC) remain controversial. The authors present two pediatric cases of hydrocephalus associated with BPC, in which the patients' hydrocephalus progressed after endoscopic third ventriculostomy (ETV), despite a patent stoma of the third ventricular floor. Case 1: A 4-year-old girl with delayed gait development was diagnosed with BPC-associated hydrocephalus and received ETV. Postoperatively, the patient presented headaches and nausea. Computed tomography (CT) scans demonstrated larger ventricles than those observed on the preoperative images. Because phase-contrast cine magnetic resonance imaging (MRI) and constructive interference in steady state (CISS) MRI revealed patent cerebrospinal fluid (CSF) flow at the third ventricular floor level, a ventriculoperitoneal shunt (VPS) was placed using a programmable pressure valve to treat the hydrocephalus. Case 2: A 6-year-old girl with newly developed repeated convulsive seizures was diagnosed with BPC-associated hydrocephalus and received ETV. Phase-contrast cine MRI on the 5th postoperative day showed hyperdynamic CSF flow at the third ventricular floor level. She also developed vomiting and headache...Continue Reading

References

Jun 1, 1991·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·H Arai, K Sato
Aug 19, 2004·Pediatric Radiology·Marvin D NelsonFloyd H Gilles
Mar 4, 2010·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Erwin M J CornipsJohannes S H Vles
Apr 7, 2010·Journal of Neurosurgery. Pediatrics·Hirokazu TakamiNobuhito Saito
Dec 8, 2011·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Vino ApokJonathan Roth
Aug 29, 2013·Arquivos de neuro-psiquiatria·Carlos Vicente Brusius, Sergio Cavalheiro

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