Aqueduct stenosis and schizophrenia.
Reveley A M,Reveley M A
Journal of neurology, neurosurgery, and psychiatry
Three patients with hydrocephalus and aqueduct stenosis are described, who also have schizophrenia defined according to strict diagnostic criteria. There are no previous reports of such an association.
10.1136/jnnp.46.1.18
Schizophrenic psychosis associated with aqueduct stenosis in adults.
Roberts J K,Trimble M R,Robertson M
Journal of neurology, neurosurgery, and psychiatry
The case histories of five adult patients with hydrocephalus and aqueduct stenosis are presented. All the cases were associated with prominent psychotic symptoms (delusions, hallucinations or thought disorder). In the three cases where operative intervention was carried out the diagnosis was made in adult life. Using the Present State Examination all five cases were classified as having schizophrenic psychosis. The possible reasons for this association are discussed.
10.1136/jnnp.46.10.892
Schizophrenic psychosis and associated aqueduct stenosis.
O'Flaithbheartaigh S,Williams P A,Jones G H
The British journal of psychiatry : the journal of mental science
In two adults, both schizophrenia and hydrocephalus were associated with aqueduct stenosis. The prevalence is argued to be above chance, and may contribute to the neurodevelopmental hypothesis of the causality of schizophrenia.
10.1192/bjp.164.5.684
Measurement of cerebrospinal fluid flow at the cerebral aqueduct by use of phase-contrast magnetic resonance imaging: technique validation and utility in diagnosing idiopathic normal pressure hydrocephalus.
Luetmer Patrick H,Huston John,Friedman Jonathan A,Dixon Geoffrey R,Petersen Ronald C,Jack Clifford R,McClelland Robyn L,Ebersold Michael J
Neurosurgery
OBJECTIVE:We analyzed the reliability of a protocol for measuring quantitative cerebrospinal fluid (CSF) flow at the cerebral aqueduct and established the range of CSF flows in normal elderly patients, patients with Alzheimer's and other forms of dementia, and patients with idiopathic normal pressure hydrocephalus (NPH). METHODS:A constant flow phantom was used to establish the accuracy of the CSF flow measurement. The clinical variability of the measurement was estimated by calculating the standard deviations and coefficients of variation of intra- and interobserver and intertrial data sets derived from three normal volunteers. A total of 236 patients were studied, including 47 normal elderly patients, 115 patients with cognitive impairment (9 with mild cognitive impairment, 46 with Alzheimer's disease, and 60 with other cognitive impairment), 31 patients in whom NPH was suspected but ultimately excluded, and 43 patients with a final clinical diagnosis of NPH. RESULTS:The intraobserver, interobserver, and intertrial measurement variations of 6.4, 5.4, and 8.8%, respectively, were substantially smaller than the wide variation observed among subjects. There was no statistically significant difference in flow between normal elderly patients and patients with cognitive impairment (P = 0.91). When these populations were pooled, the average flow was 8.47 ml/min (standard deviation, 4.23; range, 0.9-18.5 ml/min). The average flow rate in patients with a final clinical diagnosis of NPH was 27.4 ml/min (standard deviation, 15.3; range, 3.13-62.2 ml/min). This was significantly higher than the flow rate in each of the other three groups (all, P < 0.001). CONCLUSION:CSF flow measurements of less than 18 ml/min with a sinusoidal flow pattern are normal. CSF flow of greater than 18 ml/min suggests idiopathic NPH.
10.1097/00006123-200203000-00020
[Clinical aspects and therapy of adult hydrocephalus associated with stenosis of the aqueduct of Sylvius].
Procházková V,Kostková H,Bret J
Ceskoslovenska neurologie a neurochirurgie
The author describes 11 cases of adult hydrocephalus based on stenosis of the aqueduct of Sylvius. She describes clinical manifestations and diagnostic possibilities. CT examination and positive VG are most useful for the diagnosis. Clinical signs of rising intracranial pressure, considerable narrowing of or absence of the filling of the aqueduct and hydrocephalus are in the author's opinion the most important criteria of operation. Recanalization of the aqueduct of Sylvius by a drainage tube according to Bret is the optimal surgical approach.
Stenosis of the aqueduct of Sylvius. Etiology and treatment.
Hirsch J F,Hirsch E,Sainte Rose C,Renier D,Pierre-Khan A
Journal of neurosurgical sciences
Etiology, mechanism and treatment remain controversial in aqueductal stenosis. The review of 114 cases operated on between 1975 and 1982 in the Service of Pediatric Neurosurgery of "Les Enfants-Malades" in Paris was undertaken with the hope of improving our understanding of these problems. Toxoplasmosis was in our series the most frequent etiology, accounting for 15% of the cases; 74% of the aqueductal stenoses in this series were of unknown origin. In two cases, a small arachnoid cyst, developed in contact with the ambient cistern, was the cause of the aqueductal stenosis. In about half of the 32 pneumoencephalograms performed, a rounded, dilated ambient cistern was found. No such dilatation was observed in 35 pneumoencephalograms performed in cases of communicating hydrocephalus. It is likely that some cases of aqueductal stenoses are the consequence of a compression of the brain stem by an overpressurized ambient cistern, whether communicating or not with the subarachnoid spaces. Although the ventricular volume is less reduced after percutaneous ventriculostomy than after shunting, the long term results of the two treatments are comparable. The risk of infection is lower with ventriculostomies, but the rate of failures is higher. Since ventriculocisternostomy is a safe procedure when patients are properly selected, it can be tested first, a shunt being inserted at a later time in case of failure.
Endoscopic aqueductoplasty.
Erşahin Yusuf
Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
OBJECTIVE:Endoscopic aqueductoplasty (EA) was considered as a good alternative to endoscopic third ventriculostomy (ETV) in selected patients. A personal experience on EA is presented in this paper. MATERIALS AND METHODS:Forty-five patients with primary or secondary aqueductal stenosis underwent EA with or without a stent between June 2000 and June 2005. Age, gender, diagnosis, endoscopic procedures, complications, and outcome were reviewed. EA was considered successful when patients with noncommunicating hydrocephalus became shunt-free. When the patient did not need a fourth ventricular shunt after the EA with or without a stent, it was considered to be successful in patients with isolated fourth ventricle. RESULTS:Fifteen patients were older than 18 years of age. EA, EA with stent, EA with ETV, and EA with stent in addition to ETV were performed in 11, 6, 11, and 17 patients, respectively. Out of 45 patients who had undergone EA with or without stent and ETV, 31 (69%) benefited from the endoscopic procedures. The type of the endoscopic procedure, diagnosis, and the age of the patients did not significantly affect the outcome. CONCLUSION:EA with a stent can be performed in patients with isolated fourth ventricle and in patients with aqueduct stenosis in which ETV is not feasible. EA can be dangerous and useless in aqueduct stenosis (AS), and EA with ETV is even more useless. Those patients who have undergone EA should be closely followed up for a long period of time because restenosis of the aqueduct and stent migration may happen years after endoscopic surgery.
10.1007/s00381-006-0227-z
Hydrocephalus in aqueductal stenosis.
Cinalli Giuseppe,Spennato Pietro,Nastro Anna,Aliberti Ferdinando,Trischitta Vincenzo,Ruggiero Claudio,Mirone Giuseppe,Cianciulli Emilio
Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
INTRODUCTION:The sylvian aqueduct is the most common site of intraventricular blockage of the cerebro-spinal fluid. Clinical aspects, neuroradiological appearance, and treatment of hydrocephalus secondary to aqueductal stenosis are specific. METHODS:An extensive literature review concerning etiologic, pathogenetic, clinical, and neuroradiological aspects has been performed. Therapeutic options, prognosis, and intellectual outcome are also reviewed. CONCLUSION:The correct interpretation of the modern neuroradiologic techniques may help in selecting adequate treatment between the two main options (third ventriculostomy or shunting). In the last decades, endoscopic third ventriculostomy has become the first-line treatment of aqueductal stenosis; however, some issues, such as the cause of failures in well selected patients, long-term outcome in infant treated with ETV, and effect of persistent ventriculomegaly on neuropsychological developmental, remain unanswered.
10.1007/s00381-011-1546-2
Classification of Chronic Hydrocephalus in Adults: A Systematic Review and Analysis.
World neurosurgery
BACKGROUND:Chronic hydrocephalus in adults (CHiA) includes all nonacute forms of hydrocephalus occurring in adulthood. It covers a spectrum of disorders. Some of these have relatively agreed on definitions, while others are less well characterized. The existing medical classification systems lack adequate structure and are neither clinically oriented nor easy to use, which severely hampers research and clinical care efforts. METHODS:A systematic literature review and data analysis were performed, focusing on the terms "adult hydrocephalus" and "classification," using the PubMed, Scopus, and Cochrane Library databases. Data on terminology, definitions, patient demographics, symptom duration, and clinical presentations were extracted, analyzed, and compiled. A Delphi process was followed to define CHiA disorders. RESULTS:A total of 33 studies collectively used 48 terms to define various CHiA disorders. Different terms were used to describe similar conditions. CHiA disorders were found to be clustered into 7 distinctive clinical entities based on the clinical characteristics. CONCLUSIONS:An evidence-based new clinical classification for CHiA is suggested. Our review identified gaps in knowledge and areas for further research.
10.1016/j.wneu.2023.12.094
Sylvius aqueduct septum.
Coolen T,Médart L,Tebache M,Collignon L
JBR-BTR : organe de la Societe royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR)
We present a case of chronic hydrocephalus discovered in adulthood through an episode of acute decompensation. Multimodal imaging revealed the cause of this hydrocephalus to be a membranous septum of the aqueduct of Sylvius, a condition for which few reports exist.
10.5334/jbr-btr.464