CT stereotaxy guided lateral trans-cerebellar programmable fourth ventriculo–peritoneal shunting for symptomatic trapped fourth ventricle

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• 作者：Sharma ; Rewati Raman ; Pawar ; Sanjay J. ; Devadas ; R.V. ; Dev ; Ebenezer J.
• 关键词：Trapped fourth ventricle ; Lateral trans-cerebellar stereotaxy ; Bobble head doll syndrome ; Bilateral abducens palsy ; Programmable shunt ; Ventriculo&ndash ; peritoneal shunt
• 刊名：Clinical Neurology and Neurosurgery
• 出版年：2001
• 期刊代码：60_03038467
• 类别：med
• 出版时间：October, 2001
• 卷：103
• 期：3
• 页码：143-146
• 文件大小：126 K

摘要

A trapped fourth ventricle is a rare clinico-radiological entity producing symptoms suggestive of a progressive posterior fossa mass lesion. It is mainly reported in children as a late complication of lateral ventricular shunting to relieve infantile post-meningitic or post-hemorrhagic hydrocephalus. Optional treatment of the trapped fourth ventricle remains controversial. Placement of fourth ventricular shunting via a conventional midline approach can be fraught with complications in about 40%of the patients. Authors report a successful CT Stereotaxy guided high pressure (80 mm H₂O) programmable fourth ventriculo–peritoneal shunting via a lateral trans-cerebellar approach in a 14-year-old girl with a trapped fourth ventricle, which occurred as a late complication of ventriculo-peritoneal shunting in her infancy. Her preoperative symptoms of raised intracranial pressure, bobble-head doll syndrome and bilateral abducens palsies completely improved following the surgery. Lateral trans-cerebellar stereotactic placement of the fourth ventricular catheter and the use of high-pressure (low flow) programmable shunt (to avoid complications associated with over drainage) are beneficial in some patients with trapped fourth ventricle.