The isolated fourth ventricle. (3rd April 2013)

• Record Type: Journal Article
• Authors: Ali, Khalid; Nannapaneni, Ravindra; Hamandi, Khalid
• Is Part Of: BMJ case reports. Volume 2013
• Publication Date: 2013-04-03
• Subjects: Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2013-008791
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Isolated enlargement of the fourth ventricle, or 'encysted' fourth ventricle is a rare late complication following shunt insertion of the lateral ventricles for hydrocephalus. Caudal and rostral obstruction of the fourth ventricle and its subsequent dilation results in compression of adjacent cerebellum and brain stem structures; treatment with further shunt insertion directly to the fourth ventricle is invariably successful. There is potential for diagnostic delay, when clinical symptoms and signs of cerebellar and brain stem compromise are unrecognised or attributed to other factors, and attention on the CT is focused on the lateral ventricular system and the already existing ventriculoperitoneal shunt, which will appear unchanged from previous scans. We report two cases with isolated fourth ventricular obstruction and review the literature to highlight the importance of recognising this condition.