Journal articles: 'Cerebral aqueduct'

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Longatti, Pierluigi, Alessandro Fiorindi, Alessandro Perin, and Andrea Martinuzzi. "Endoscopic Anatomy of the Cerebral Aqueduct." Operative Neurosurgery 61, suppl_3 (September 1, 2007): ONS—1—ONS—6. http://dx.doi.org/10.1227/01.neu.0000289705.64931.0c.

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Abstract Objective: What is known about the cerebral aqueduct is derived mainly from the legacy of classic histology and from the most recent advanced neuroimaging technologies. In fact, although this important structure is frequently glimpsed by neurosurgeons, only limited anatomic contributions have been added by microsurgery to its direct in vivo description. A review of our surgical experience in navigating the fourth ventricle prompted us to revisit the classical anatomic descriptions of the aqueduct and compare them using the novel perspective of neuroendoscopy. Methods: We reviewed video recordings of 65 transaqueductal explorations of the fourth ventricle using flexible endoscopes, which were performed in our center to treat various pathological conditions. Forty-one patients were selected as being more informative for anatomic description. They include 21 patients with communicating normal pressure hydrocephalus, 6 patients with intraventricular hemorrhage, 5 patients with membranous obstruction of the foramen of Magendie, 5 patients with trapped fourth ventricle as evidenced after aqueductoplasty, 3 patients with colloid cysts, and 1 patient with craniopharyngioma with apparently normal aqueduct, which was navigated to aspirate small fragments of colloid and tiny clots. Results: Patients with normal-sized third ventricles confirmed the typical triangular shape of the aqueductal adytum, whereas all pathological aqueducts invariably had an oval contour. The posterior commissure, a faint trace of the median sulcus, and the rubral eminences were the structures invariably noticed. Five segments of the aqueduct were always identifiable: the adytum, first constriction, ampulla, second constriction, and posterior part or egressus. Conclusion: Neuroendoscopy provides a novel perspective into the inner aqueductal wall and supplies an incomparable view of the intracanalicular anatomic structures.

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Stankovic, Gordana, Valentina Nikolic, Laslo Puskas, Branislav Filipovic, Ljubica Stojsic-Dzunja, and Dragan Krivokuca. "A histological study of cerebral aqueduct." Medical review 58, no. 11-12 (2005): 534–40. http://dx.doi.org/10.2298/mpns0512534s.

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Cerebral (sylvian) aqueduct is a narrow channel in the mesencephalon. It lies between the tectum and the tegmentum of the mesencephalon and is surrounded by the periaqueductal gray matter. The aim of this study was to determine the shape of the . aqueduct of sylvius and the structure of its walls in a series of transverse histological sections. Serial transverse sections of the mesencephalon were examined in twenty adult brains of both sexes. Six sections were stained by the hematoxyiin-eosin method. The rostral part of the the aqueduct has a triangular shape with dorsal concavity caused by retrocommissural fossae. In the middle, its shape is oval to irregular, the rostral part has a T shape due to isthmic recess on the floor. Walls of the aqueduct are coated with a layer of prismatic cells. Determination of the morphological and histological features of the mesencephalic aqueduct is important for differentiation between physiological and pathological processes in this region.

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Hamilton, Robert, Kevin Baldwin, Jennifer Fuller, Paul Vespa, Xiao Hu, and Marvin Bergsneider. "Intracranial pressure pulse waveform correlates with aqueductal cerebrospinal fluid stroke volume." Journal of Applied Physiology 113, no. 10 (November 15, 2012): 1560–66. http://dx.doi.org/10.1152/japplphysiol.00357.2012.

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This study identifies a novel relationship between cerebrospinal fluid (CSF) stroke volume through the cerebral aqueduct and the characteristic peaks of the intracranial pulse (ICP) waveform. ICP waveform analysis has become much more advanced in recent years; however, clinical practice remains restricted to mean ICP, mainly due to the lack of physiological understanding of the ICP waveform. Therefore, the present study set out to shed some light on the physiological meaning of ICP morphological metrics derived by the morphological clustering and analysis of continuous intracranial pulse (MOCAIP) algorithm by investigating their relationships with a well defined physiological variable, i.e., the stroke volume of CSF through the cerebral aqueduct. Seven patients received both overnight ICP monitoring along with a phase-contrast MRI (PC-MRI) of the cerebral aqueduct to quantify aqueductal stroke volume (ASV). Waveform morphological analysis of the ICP signal was performed by the MOCAIP algorithm. Following extraction of morphological metrics from the ICP signal, nine temporal ICP metrics and two amplitude-based metrics were compared with the ASV via Spearman's rank correlation. Of the nine temporal metrics correlated with the ASV, only the width of the P2 region (ICP-Wi2) reached significance. Furthermore, both ICP pulse pressure amplitude and mean ICP did not reach significance. In this study, we showed the width of the second peak (ICP-Wi2) of an ICP pulse wave is positively related to the volume of CSF movement through the cerebral aqueduct. This finding is an initial step in bridging the gap between ICP waveform morphology research and clinical practice.

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Sola, Joaquin, Isabel Arcas, Juan F. Martinez-Lage, Miguel Martinez Perez, Juan A. Esteban, and M�ximo Poza. "Astrocytoma of the cerebral aqueduct." Child's Nervous System 3, no. 5 (December 1987): 294–96. http://dx.doi.org/10.1007/bf00271827.

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Kramer, Larry A., Khader M. Hasan, Ashot E. Sargsyan, Karina Marshall-Goebel, Jörn Rittweger, Dorit Donoviel, Saki Higashi, Benson Mwangi, Darius A. Gerlach, and Eric M. Bershad. "Quantitative MRI volumetry, diffusivity, cerebrovascular flow, and cranial hydrodynamics during head-down tilt and hypercapnia: the SPACECOT study." Journal of Applied Physiology 122, no. 5 (May 1, 2017): 1155–66. http://dx.doi.org/10.1152/japplphysiol.00887.2016.

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To improve the pathophysiological understanding of visual changes observed in astronauts, we aimed to use quantitative MRI to measure anatomic and physiological responses during a ground-based spaceflight analog (head-down tilt, HDT) combined with increased ambient carbon dioxide (CO2). Six healthy, male subjects participated in the double-blinded, randomized crossover design study with two conditions: 26.5 h of −12° HDT with ambient air and with 0.5% CO2, both followed by 2.5-h exposure to 3% CO2. Volume and mean diffusivity quantification of the lateral ventricle and phase-contrast flow sequences of the internal carotid arteries and cerebral aqueduct were acquired at 3 T. Compared with supine baseline, HDT (ambient air) resulted in an increase in lateral ventricular volume ( P = 0.03). Cerebral blood flow, however, decreased with HDT in the presence of either ambient air or 0.5% CO2( P = 0.002 and P = 0.01, respectively); this was partially reversed by acute 3% CO2exposure. Following HDT (ambient air), exposure to 3% CO2increased aqueductal cerebral spinal fluid velocity amplitude ( P = 0.01) and lateral ventricle cerebrospinal fluid (CSF) mean diffusivity ( P = 0.001). We concluded that HDT causes alterations in cranial anatomy and physiology that are associated with decreased craniospinal compliance. Brief exposure to 3% CO2augments CSF pulsatility within the cerebral aqueduct and lateral ventricles.NEW & NOTEWORTHY Head-down tilt causes increased lateral ventricular volume and decreased cerebrovascular flow after 26.5 h. Additional short exposure to 3% ambient carbon dioxide levels causes increased cerebrovascular flow associated with increased cerebrospinal fluid pulsatility at the cerebral aqueduct. Head-down tilt with chronically elevated 0.5% ambient carbon dioxide and acutely elevated 3% ambient carbon dioxide causes increased mean diffusivity of cerebral spinal fluid within the lateral ventricles.

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Lucic, Milos, Katarina Koprivsek, Viktor Till, and Zoran Vesic. "Dynamic magnetic resonance imaging of the cerebrospinal fluid flow within the cerebral aqueduct by different FISIP 2D sequences." Vojnosanitetski pregled 67, no. 5 (2010): 357–63. http://dx.doi.org/10.2298/vsp1005357l.

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Background/Aim. A vast majority of current radiogical techniques, such as computerized tomography (CT) and magnetic resonance imaging (MRI) have great potential of visualization and delineation of cerebrospinal fluid spaces morphology within cerebral aqueduct. The aim of this study was to determine the possibilities of two differently acquired FISP (Fast Imaging with Steady State Precession) 2D MR sequences in the estimation of the pulsatile cerebrospinal fluid (CSF) flow intensity through the normal cerebral aqueduct. Methods. Sixty eight volunteers underwent brain MRI on 1.5T MR imager with additionally performed ECG retrospectively gated FISP 2D sequences (first one, as the part of the standard software package, with following technical parameters: TR 40, TE 12, FA 17, Matrix: 192 ? 256, Acq 1, and the second one, experimentally developed by our investigation team: TR 30, TE 12, FA 70, Matrix: 192 ? 256, Acq 1) respectively at two fixed slice positions - midsagittal and perpendicular to cerebral aqueduct, displayed and evaluated by multiplegated images in a closed-loop cinematographic (CINE) format. Results. Normal brain morphology with preserved patency of the cerebral aqueduct in all of 68 healthy volunteers was demonstrated on MRI examination. Cerebrospinal fluid flow within the cerebral aqueduct was distinguishable on both CINE MRI studies in midsagittal plane, but the estimation of intraaqueductal CSF flow in perpendicular plane was possible on CINE MRI studies acquired with experimentally improved FISP 2D (TR 30, FA 70) sequence only. Conclusion. Due to the changes of technical parameters CINE MRI study acquired with FISP 2D (TR 30, FA 70) in perpendicular plane demonstrated significantly higher capability in the estimation of the CSF pulsation intensity within the cerebral aqueduct. .

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Markenroth Bloch, Karin, Johannes Töger, and Freddy Ståhlberg. "Investigation of cerebrospinal fluid flow in the cerebral aqueduct using high-resolution phase contrast measurements at 7T MRI." Acta Radiologica 59, no. 8 (November 15, 2017): 988–96. http://dx.doi.org/10.1177/0284185117740762.

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Background The cerebral aqueduct is a central conduit for cerebrospinal fluid (CSF), and non-invasive quantification of CSF flow in the aqueduct may be an important tool for diagnosis and follow-up of treatment. Magnetic resonance (MR) methods at clinical field strengths are limited by low spatial resolution. Purpose To investigate the feasibility of high-resolution through-plane MR flow measurements (2D-PC) in the cerebral aqueduct at high field strength (7T). Material and Methods 2D-PC measurements in the aqueduct were performed in nine healthy individuals at 7T. Measurement accuracy was determined using a phantom. Aqueduct area, mean velocity, maximum velocity, minimum velocity, net flow, and mean flow were determined using in-plane resolutions 0.8 × 0.8, 0.5 × 0.5, 0.3 × 0.3, and 0.2 × 0.2 mm2. Feasibility criteria were defined based on scan time and spatial and temporal resolution. Results Phantom validation of 2D-PC MR showed good accuracy. In vivo, stroke volume was −8.2 ± 4.4, −4.7 ± 2.8, −6.0 ± 3.8, and −3.7 ± 2.1 µL for 0.8 × 0.8, 0.5 × 0.5, 0.3 × 0.3, and 0.2 × 0.2 mm2, respectively. The scan with 0.3 × 0.3 mm2 resolution fulfilled the feasibility criteria for a wide range of heart rates and aqueduct diameters. Conclusion 7T MR enables non-invasive quantification of CSF flow and velocity in the cerebral aqueduct with high spatial resolution.

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Feletti, Alberto, Stavros Dimitriadis, and Giacomo Pavesi. "Cavernous Angioma of the Cerebral Aqueduct." World Neurosurgery 98 (February 2017): 876.e15–876.e22. http://dx.doi.org/10.1016/j.wneu.2016.11.096.

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Jacobson, Erica E., David F. Fletcher, Michael K. Morgan, and Ian H. Johnston. "Fluid Dynamics of the Cerebral Aqueduct." Pediatric Neurosurgery 24, no. 5 (1996): 229–36. http://dx.doi.org/10.1159/000121044.

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Feletti, Alberto, Alessandro Fiorindi, and Pierluigi Longatti. "Split cerebral aqueduct: a neuroendoscopic illustration." Child's Nervous System 32, no. 1 (August 1, 2015): 199–203. http://dx.doi.org/10.1007/s00381-015-2827-y.

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MacRae, Cassie, and Hemant Varma. "Chronic Hydrocephalus Following Mumps Encephalitis: Neuropathological Correlates and Review." Journal of Neuropathology & Experimental Neurology 79, no. 1 (December 10, 2019): 113–17. http://dx.doi.org/10.1093/jnen/nlz117.

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Abstract Hydrocephalus is a rare and devastating complication of mumps encephalitis. The histopathological correlates of mumps infection in central nervous system tissues are not well-characterized. We present the case of a 54-year-old patient who suffered long-term neuropsychiatric sequelae and hydrocephalus as a consequence of a childhood mumps infection. Brain autopsy revealed significant dilation of the lateral and third ventricles. Aqueductal stenosis was not observed on premortem imaging or on gross examination. Histology revealed loss of ependymal epithelium throughout the aqueduct and ventricular system. Macrophage conglomerates were identified within the cerebral aqueduct at the level of the pons in addition to subjacent periaqueductal gliosis and scattered Rosenthal fibers. Together, these findings support primary ependymal injury as a pathophysiological mechanism in the development of chronic hydrocephalus following mumps infection. Finally, we review the existing literature and discuss potential mechanisms of disease.

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Gallagher, Andrew C., and John Q. Trounce. "Cerebral aqueduct stenosis presenting with limb pain." Developmental Medicine & Child Neurology 40, no. 5 (November 12, 2008): 349–51. http://dx.doi.org/10.1111/j.1469-8749.1998.tb15388.x.

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Kemp, S. S., R. A. Zimmerman, L. T. Bilaniuk, D. B. Hackney, H. I. Goldberg, and R. I. Grossman. "Magnetic resonance imaging of the cerebral aqueduct." Neuroradiology 29, no. 5 (September 1987): 430–36. http://dx.doi.org/10.1007/bf00341738.

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Yaghi, Shadi, and Archana Hinduja. "Spontaneous resolution of obstructive hydrocephalus from blood in the cerebral aqueduct." Clinics and Practice 1, no. 1 (April 7, 2011): 15. http://dx.doi.org/10.4081/cp.2011.e15.

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Obstructive hydrocephalus is a neurological emergency that needs to be immediately identified and treated. It very rarely resolves without treatment. We report about an 86-year-old man with right frontal stroke who developed obstructive hydrocephalus caused by blood in the cerebral aqueduct. The patient had sudden and immediate clinical improvement and a repeated head computed tomography (CT) scan showing spontaneous resolution of hydrocephalus. Spontaneous resolution of obstructive hydrocephalus is possible when the cause is minimal blood in the cerebral aqueduct without any blood in the fourth ventricle.

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Rashid, Shams, James P. McAllister, Yiting Yu, and Mark E. Wagshul. "Neocortical Capillary Flow Pulsatility is Not Elevated in Experimental Communicating Hydrocephalus." Journal of Cerebral Blood Flow & Metabolism 32, no. 2 (September 21, 2011): 318–29. http://dx.doi.org/10.1038/jcbfm.2011.130.

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While communicating hydrocephalus (CH) is often characterized by increased pulsatile flow of cerebrospinal fluid (CSF) in the cerebral aqueduct, a clear-cut explanation for this phenomenon is lacking. Increased pulsatility of the entire cerebral vasculature including the cortical capillaries has been suggested as a causative mechanism. To test this theory, we used two-photon microscopy to measure flow pulsatility in neocortical capillaries 40 to 500 μm below the pial surface in adult rats with CH at 5 to 7 days (acute, n=8) and 3 to 5 weeks (chronic, n=5) after induction compared with intact controls ( n=9). Averaging over all cortical depths, no increase in capillary pulsatility occurred in acute (pulsatility index (PI): 0.15±0.06) or chronic (0.14±0.05) CH animals compared with controls (0.18±0.07; P=0.07). More specifically, PI increased significantly with cortical depth in controls ( r=0.35, P<0.001), but no such increase occurred in acute ( r=0.06, P=0.3) or chronic ( r=0.05, P=0.5) CH. Pulsatile CSF aqueductal flow, in contrast, was elevated 10- to 500-fold compared with controls. We conclude that even in the presence of markedly elevated pulsatile CSF flow in the aqueduct, there is no concurrent increase in microvascular pulsatile flow.

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Procenko, Elena V., Lubov P. Peretiatko, Natalya V. Fateeva, and Olga P. Saryeva. "Pathomorphology of hydrocephalus associated with anomalies of development of the cerebral aqueduct." I.P. Pavlov Russian Medical Biological Herald 26, no. 3 (October 9, 2018): 337–44. http://dx.doi.org/10.23888/pavlovj2018263337-344.

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Aim. The aim of the study was to reveal structural peculiarities of the ventricular germinal zone and of the neocortex in newborns of 22-40 weeks gestation with congenital hydrocephalus associated with anomalies in development of the cerebral aqueduct. Materials and Methods. The main group was the brain of newborns aged 22-40 weeks of gestation with hydrocephalus, formed with the underlying developmental anomalies of the cerebral aqueduct (n=10); comparison group (n=30) was the brain of newborns without visible pathology of the CNS with the width of the lumen of lateral ventricles not exceeding 0.5 cm. A complex pathomorphological study of the ventricular germinal zone and the neocortex in the projection of field No. 6 (cortical representation of the motor analyzer) was carried out. Results. Hydrocephalus associated with anomalies of development of the cerebral aqueduct is characterized by disorders in formation of sulci and gyri (micropolygyria, asymmetry and breakage of the gyrification sequence), by absence of signs of remodeling of the ventricular germinal zone and by retardation of differentiation of III-VI cytoarchitectonic layers of the neocortex, with the underlying increased expression of S-100 glial protein in glioblasts of white matter, decreased expression of vimentin in vessels of periventricular region, negative expression of metalloproteinases-9 in glioblasts, of reelin in Cajal-Retzius neurons, of desmin in periventricular vessels. Conclusion. Structural peculiarities of the ventricular germinal zone and the neocortex in newborns of 22-40 weeks of gestation with hydrocephalus, associated with anomalies in development of the cerebral aqueduct, should be considered as morphological diagnostic criteria for differentiation of the given pathology with internal hydrocephalus of a different etiology.

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Procenko, Elena V., Lubov P. Peretiatko, Natalya V. Fateeva, and Olga P. Saryeva. "Pathomorphology of hydrocephalus associated with anomalies of development of the cerebral aqueduct." I.P. Pavlov Russian Medical Biological Herald 26, no. 3 (October 9, 2018): 337–44. http://dx.doi.org/10.23888/pavlovj20183337-344.

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Aim. The aim of the study was to reveal structural peculiarities of the ventricular germinal zone and of the neocortex in newborns of 22-40 weeks gestation with congenital hydrocephalus associated with anomalies in development of the cerebral aqueduct. Materials and Methods. The main group was the brain of newborns aged 22-40 weeks of gestation with hydrocephalus, formed with the underlying developmental anomalies of the cerebral aqueduct (n=10); comparison group (n=30) was the brain of newborns without visible pathology of the CNS with the width of the lumen of lateral ventricles not exceeding 0.5 cm. A complex pathomorphological study of the ventricular germinal zone and the neocortex in the projection of field No. 6 (cortical representation of the motor analyzer) was carried out. Results. Hydrocephalus associated with anomalies of development of the cerebral aqueduct is characterized by disorders in formation of sulci and gyri (micropolygyria, asymmetry and breakage of the gyrification sequence), by absence of signs of remodeling of the ventricular germinal zone and by retardation of differentiation of III-VI cytoarchitectonic layers of the neocortex, with the underlying increased expression of S-100 glial protein in glioblasts of white matter, decreased expression of vimentin in vessels of periventricular region, negative expression of metalloproteinases-9 in glioblasts, of reelin in Cajal-Retzius neurons, of desmin in periventricular vessels. Conclusion. Structural peculiarities of the ventricular germinal zone and the neocortex in newborns of 22-40 weeks of gestation with hydrocephalus, associated with anomalies in development of the cerebral aqueduct, should be considered as morphological diagnostic criteria for differentiation of the given pathology with internal hydrocephalus of a different etiology.

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Stoquart-ElSankari, Souraya, Olivier Balédent, Catherine Gondry-Jouet, Malek Makki, Olivier Godefroy, and Marc-Etienne Meyer. "Aging Effects on Cerebral Blood and Cerebrospinal Fluid Flows." Journal of Cerebral Blood Flow & Metabolism 27, no. 9 (February 21, 2007): 1563–72. http://dx.doi.org/10.1038/sj.jcbfm.9600462.

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Phase-contrast magnetic resonance imaging (PC-MRI) is a noninvasive reliable technique, which enables quantification of cerebrospinal fluid (CSF) and total cerebral blood flows (tCBF). Although it is used to study hydrodynamic cerebral disorders in the elderly group (hydrocephalus), there is no published evaluation of aging effects on both tCBF and CSF flows, and on their mechanical coupling. Nineteen young (mean age 27 ± 4 years) and 12 elderly (71 ± 9 years) healthy volunteers underwent cerebral MRI using 1.5 T scanner. Phase-contrast magnetic resonance imaging pulse sequence was performed at the aqueductal and cervical levels. Cerebrospinal fluid and blood flow curves were then calculated over the cardiac cycle, to extract the characteristic parameters: mean and peak flows, their latencies, and stroke volumes for CSF (cervical and aqueductal) and vascular flows. Total cerebral blood flow was ( P < 0.01) decreased significantly in the elderly group when compared with the young subjects with a linear correlation with age observed only in the elderly group ( R2 = 0.7; P = 0.05). Arteriovenous delay was preserved with aging. The CSF stroke volumes were significantly reduced in the elderly, at both aqueductal ( P < 0.01) and cervical ( P < 0.05) levels, whereas aqueduct/cervical proportion ( P = 0.9) was preserved. This is the first work to study aging effects on both CSF and vascular cerebral flows. Data showed (1) tCBF decrease, (2) proportional aqueductal and cervical CSF pulsations reduction as a result of arterial loss of pulsatility, and (3) preserved intracerebral compliance with aging. These results should be used as reference values, to help understand the pathophysiology of degenerative dementia and cerebral hydrodynamic disorders as hydrocephalus.

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Stankovic, Gordana, Biljana Vitosevic, Dorentina Bexheti, Kristina Davidovic, Aleksandra Dozic, Ana Zekavica, Branislava Curcic, Zdravko Vitosevic, and Milan Milisavljevic. "Anatomical and MRI relations of the cerebral aqueduct to the adjacent parts of the brain and calvaria." Srpski arhiv za celokupno lekarstvo 145, no. 7-8 (2017): 357–63. http://dx.doi.org/10.2298/sarh160629057s.

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Introducton/Objective. Insufficiency of relevant anatomic data and great neurological and neurosurgical significance were the reasons for this study with scientific and practical implications. The purpose was to determine, at the transverse in situ section of the head, the position and relations of the sylvian aqueduct of the mesencephalon by measuring its distances from particular brain and calvaria structures. Also, the aim was to determine the same distances according to axial sections by using MRI. Methods. The material consisted of twenty autopsy human heads. The section of the head was made at the level of the tentorial hiatus and the midbrain. After that, we measured the distances between the cerebral aqueduct and a) posterior border of the optic chiasm, b) upper border of the dorsum sellae, c) terminal bifurcation of the basilar artery, d) beginning of the straight sinus, e) internal occipital protuberance, f) tentorial edge (lateral from the aqueduct), and g) internal surface of the calvaria (lateral to the aqueduct). We determined the same distances by the MRI system. The measurements were made in 37 subjects. Results. The numerical data obtained by this study will be of benefit to neurosurgeons in choosing a surgical approach to the contents of the incisural space, and to neurologists for the exact localization of the lesion and interpretation of certain signs and symptoms. Conclusion. The results of a detailed examination of the sylvian aqueduct position and relations have shown that the use of MRI is the morphometric method of choice, because it is more precise for all the parameters monitored than in situ measurements.

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Jittapiromsak, Pakrit, Hakan Sabuncuoglu, Pushpa Deshmukh, Robert F. Spetzler, and Mark C. Preul. "Accessing the Recesses of the Fourth Ventricle: Comparison of Tonsillar Retraction and Resection in the Telovelar Approach." Operative Neurosurgery 66, suppl_1 (March 1, 2010): ons—30—ons—40. http://dx.doi.org/10.1227/01.neu.0000348558.35921.4e.

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Abstract Objective: To compare the effectiveness of the telovelar approach with tonsillar manipulation for approaching the recesses of the fourth ventricle. Methods: A telovelar approach was performed in 8 injected cadaveric heads. Areas of exposure were measured for the superolateral and lateral recesses. Horizontal angles were evaluated by targeting the cerebral aqueduct and medial margin of the lateral recess. Quantitative comparisons were made between the telovelar dissections and various tonsillar manipulations. Results: Tonsillar retraction provided a comparable exposure of the superolateral recess with tonsillar resection (26.4 ± 17.6 vs 25.2 ± 12.5 mm2, respectively; P = .825). Tonsillar resection significantly increased exposure of the lateral recess compared with tonsillar retraction (31.1 ± 13.3 vs 20.2 ± 11.5 mm2, respectively; P = .002). Compared with tonsillar retraction, the horizontal angle to the lateral recess increased after either contralateral tonsillar retraction (22.7 ± 4.8 vs 36.7 ± 6.5 degrees) or tonsillar resection (22.7 ± 4.8 vs 31.5 ± 7.6 degrees; all adjusted P < .01). The horizontal angle to the cerebral aqueduct increased significantly with tonsillar resection compared with tonsillar retraction (17.6 ± 2.3 vs 13.2 ± 2.8 degrees; P < .001) Conclusion: Compared with tonsillar retraction, tonsillar resection provides a wider corridor to, and a larger area of exposure of, the cerebral aqueduct and lateral recess. Contralateral tonsillar retraction improves access to the lateral recess by widening the surgical view from the contralateral side.

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Aja, Susan, Shirin Sahandy, Ellen E. Ladenheim, Gary J. Schwartz, and Timothy H. Moran. "Intracerebroventricular CART peptide reduces food intake and alters motor behavior at a hindbrain site." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 281, no. 6 (December 1, 2001): R1862—R1867. http://dx.doi.org/10.1152/ajpregu.2001.281.6.r1862.

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Peptides from cocaine- and amphetamine-regulated transcript (CART) reduce food intake in rats when injected into the lateral ventricle. Hypothalamic and hindbrain sites important in the control of feeding contain CART-immunoreactive fibers. To further define the site of CART's anorectic action, we compared feeding and other behavioral responses to third or fourth ventricular (3V, 4V) CART-(55–102) in 6-h food-deprived rats, both before and after cerebral aqueduct occlusion. 3V CART reduced the volume of Ensure consumed and resulted in fewer observations of eating and grooming within the 30-min test session. These reductions were significantly attenuated by aqueduct obstruction. 4V CART suppressed Ensure intake and resulted in decreased observations of feeding both with and without aqueduct blockade. 3V CART produced flat-backed postures and movement-associated tremors that were prevented by aqueduct obstruction. 4V CART also produced these signs, both with and without aqueduct blockade. We conclude that the major hypophagic effect of intracerebroventricular CART is mediated at a hindbrain site. The association of CART-induced feeding suppression with altered motor behavior questions the specificity of intracerebroventricular CART for actions on feeding.

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Warf, Benjamin C., and Abhaya V. Kulkarni. "Intraoperative assessment of cerebral aqueduct patency and cisternal scarring: impact on success of endoscopic third ventriculostomy in 403 African children." Journal of Neurosurgery: Pediatrics 5, no. 2 (February 2010): 204–9. http://dx.doi.org/10.3171/2009.9.peds09304.

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Object In the setting of a developing country where preoperative imaging may be limited, the authors wished to determine whether cisternal scarring or aqueduct patency at the time of surgery was sufficiently predictive of the failure of endoscopic third ventriculostomy (ETV) to justify shunt placement at the time of the initial operation. Methods The status of the prepontine cistern and aqueduct at the time of ventriculoscopy was prospectively recorded in 403 children in whom an ETV had been completed. Kaplan-Meier methods were used to construct survival curves. A Cox proportional hazards model was used to provide estimates of HRs for the time to ETV failure. Several independent variables were tested in a single multivariable model, including those previously shown to be associated with ETV survival, that is, age, hydrocephalus etiology, and extent of choroid plexus cauterization (CPC). In addition, intraoperative variables of particular interest were included in the analysis: status of the aqueduct at surgery (closed vs open) and status of the prepontine cistern at surgery (scarred vs clean/unscarred). Multicollinearity was not a concern since the variance inflation factors for all variables were < 2. The examination of stratified survival curves confirmed the appropriateness of the proportional hazards assumption for each variable. Results Overall actuarial 3-year success was 57%. Consistent with previous results, age, hydrocephalus etiology, and extent of CPC were significantly associated with ETV success. A closed aqueduct and an unscarred cistern were each independently associated with significantly better ETV success (HRs of 0.66 and 0.44, respectively). The presence of cisternal scarring more than doubled the risk of ETV failure, and an open aqueduct increased the risk of failure by 50%. Conclusions Intraoperative observations of the aqueduct and prepontine cistern are independent predictors of the risk of ETV failure and can be used to further refine outcome predictions based on age, hydrocephalus etiology, and extent of CPC. Further studies will test validity in several African centers and determine what threshold of failure risk should prompt shunt placement at the initial operation.

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Pasquier, Baptiste, Nadja Borisow, Ludwig Rasche, Judith Bellmann-Strobl, Klemens Ruprecht, Thoralf Niendorf, Tobias J. Derfuss, Jens Wuerfel, Friedemann Paul, and Tim Sinnecker. "Quantitative 7T MRI does not detect occult brain damage in neuromyelitis optica." Neurology - Neuroimmunology Neuroinflammation 6, no. 3 (March 7, 2019): e541. http://dx.doi.org/10.1212/nxi.0000000000000541.

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ObjectiveTo investigate and compare occult damages in aquaporin-4 (AQP4)-rich periependymal regions in patients with neuromyelitis optica spectrum disorder (NMOSD) vs healthy controls (HCs) and patients with multiple sclerosis (MS) applying quantitative T1 mapping at 7 Tesla (T) in a cross-sectional study.MethodsEleven patients with NMOSD (median Expanded Disability Status Scale [EDSS] score 3.5, disease duration 9.3 years, age 43.7 years, and 11 female) seropositive for anti-AQP4 antibodies, 7 patients with MS (median EDSS score 1.5, disease duration 3.6, age 30.2 years, and 4 female), and 10 HCs underwent 7T MRI. The imaging protocol included T2*-weighted (w) imaging and an MP2RAGE sequence yielding 3D T1w images and quantitative T1 maps. We semiautomatically marked the lesion-free periependymal area around the cerebral aqueduct and the lateral, third, and fourth ventricles to finally measure and compare the T1 relaxation time within these areas.ResultsWe did not observe any differences in the T1 relaxation time between patients with NMOSD and HCs (all p > 0.05). Contrarily, the T1 relaxation time was longer in patients with MS vs patients with NMOSD (lateral ventricle p = 0.056, third ventricle p = 0.173, fourth ventricle p = 0.016, and cerebral aqueduct p = 0.048) and vs HCs (third ventricle p = 0.027, fourth ventricle p = 0.013, lateral ventricle p = 0.043, and cerebral aqueduct p = 0.005).ConclusionUnlike in MS, we did not observe subtle T1 changes in lesion-free periependymal regions in NMOSD, which supports the hypothesis of a rather focal than diffuse brain pathology in NMOSD.

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Vaill, Michael I., Bhavna N. Desai, and Ruth B. S. Harris. "Blockade of the cerebral aqueduct in rats provides evidence of antagonistic leptin responses in the forebrain and hindbrain." American Journal of Physiology-Endocrinology and Metabolism 306, no. 4 (February 15, 2014): E414—E423. http://dx.doi.org/10.1152/ajpendo.00661.2013.

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Previously, we reported that low-dose leptin infusions into the fourth ventricle produced a small but significant increase in body fat. These data contrast with reports that injections of higher doses of leptin into the fourth ventricle inhibit food intake and weight gain. In this study, we tested whether exogenous leptin in the fourth ventricle opposed or contributed to weight loss caused by third ventricle leptin infusion by blocking diffusion of CSF from the third to the fourth ventricle. Male Sprague-Dawley rats received third ventricle infusions of PBS or 0.3 μg leptin/24 h from miniosmotic pumps. After 4 days, rats received a 3-μl cerebral aqueduct injection of saline or of thermogelling nanoparticles (hydrogel) that solidified at body temperature. Third ventricle leptin infusion inhibited food intake and caused weight loss. Blocking the aqueduct exaggerated the effect of leptin on food intake and weight loss but had no effect on the weight of PBS-infused rats. Leptin reduced both body fat and lean body mass but did not change energy expenditure. Blocking the aqueduct decreased expenditure of rats infused with PBS or leptin. Infusion of leptin into the third ventricle increased phosphorylated STAT3 in the VMHDM of the hypothalamus and the medial NTS in the hindbrain. Blocking the aqueduct did not change hypothalamic p-STAT3 but decreased p-STAT3 in the medial NTS. These results support previous observations that low-level activation of hindbrain leptin receptors has the potential to blunt the catabolic effects of leptin in the third ventricle.

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Guhl, Susanne, Michael Kirsch, Heinz Lauffer, Michael Fritsch, and Henry W. S. Schroeder. "Unusual mesencephalic developmental venous anomaly causing obstructive hydrocephalus due to aqueductal stenosis." Journal of Neurosurgery: Pediatrics 8, no. 4 (October 2011): 407–10. http://dx.doi.org/10.3171/2011.7.peds114.

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Developmental venous anomalies (DVAs) are benign vascular malformations that rarely become symptomatic. They are anatomical variations of the venous drainage system and most are incidentally discovered. Mechanical (obstruction and compression of cerebral and neural structures) and flow-related pathological mechanisms have been described in rare cases of symptomatic DVAs. The authors present the case of a 10-month-old boy with a mesencephalic DVA compressing the aqueduct and causing occlusive hydrocephalus. Endoscopic inspection confirmed the venous malformation causing aqueductal stenosis. The authors successfully performed endoscopic third ventriculostomy, resulting in decrease in the size of the ventricles. At the 6-month follow-up after surgery, the patient had significantly progressed in his psychomotor development. One year postsurgery the patient is doing fine, with no neurological or developmental deficits.

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Austerman, Ryan, Joshua Lucas, Alexandra Kammen, and Gabriel Zada. "Endoscopic-Assisted Median Aperture Approach for Resection of Fourth Ventricular Tumor and Confirmation of Patency of Cerebral Aqueduct Using an Adjustable-Angle Endoscope: Technical Case Report." Operative Neurosurgery 13, no. 2 (March 20, 2017): 293–96. http://dx.doi.org/10.1093/ons/opw007.

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Abstract BACKGROUND AND IMPORTANCE: Open microsurgical approaches to the roof of the fourth ventricle via a telovelar approach typically require cerebellar retraction and/or splitting of the vermis and may be associated with postoperative neurological morbidities. In this case report and technical note, we describe the use of an adjustable-angle endoscope inserted into the median aperture via suboccipital craniotomy, resulting in enhanced visualization of the roof of the fourth ventricle and cerebral aqueduct and maximal safe tumor resection. CLINICAL PRESENTATION: A 49-yr-old woman with obstructive hydrocephalus and a fourth ventricular mass that was not fully visible with the use of an operative microscope. CONCLUSION: Direct visualization of the roof of the fourth ventricle, including the superior medullary velum and cerebral aqueduct, can be facilitated with an adjustable angle endoscope inserted into the median aperture via suboccipital craniotomy to minimize the degree of telovelar dissection and vermis splitting.

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Briggs, Robert G., Ryan G. Jones, Andrew K. Conner, Parker G. Allan, Hannah B. Homburg, B. David Maxwell, Kar-Ming Fung, and Michael E. Sughrue. "Hemangioblastoma of Cerebral Aqueduct Removed via Sitting, Supracerebellar Intracollicular Approach." World Neurosurgery 127 (July 2019): 155–59. http://dx.doi.org/10.1016/j.wneu.2019.03.206.

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Feletti, Alberto, Riccardo Stanzani, Matteo Alicandri-Ciufelli, Giuliano Giliberto, Matteo Martinoni, and Giacomo Pavesi. "Neuroendoscopic Aspiration of Blood Clots in the Cerebral Aqueduct and Third Ventricle During Posterior Fossa Surgery in the Prone Position." Operative Neurosurgery 17, no. 2 (November 28, 2018): 143–48. http://dx.doi.org/10.1093/ons/opy324.

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AbstractBACKGROUNDDuring surgery in the posterior fossa in the prone position, blood can sometimes fill the surgical field, due both to the less efficient venous drainage compared to the sitting position and the horizontally positioned surgical field itself. In some cases, blood clots can wedge into the cerebral aqueduct and the third ventricle, and potentially cause acute hydrocephalus during the postoperative course.OBJECTIVETo illustrate a technique that can be used in these cases: the use of a flexible scope introduced through the opened roof of the fourth ventricle with a freehand technique allows the navigation of the fourth ventricle, the cerebral aqueduct, and the third ventricle in order to explore the cerebrospinal fluid pathways and eventually aspirate blood clots and surgical debris.METHODSWe report on one patient affected by an ependymoma of the fourth ventricle, for whom we used a flexible neuroendoscope to explore and clear blood clots from the cerebral aqueduct and the third ventricle after the resection of the tumor in the prone position. Blood is aspirated with a syringe using the working channel of the scope as a sucker.RESULTSA large blood clot that was lying on the roof of the third ventricle was aspirated, setting the ventricle completely free. Other clots were aspirated from the right foramen of Monro and from the optic recess.CONCLUSIONWe describe this novel technique, which represents a safe and efficient way to clear the surgical field at the end of posterior fossa surgery in the prone position. The unusual endoscopic visual perspective and instrument maneuvers are easily handled with proper neuroendoscopic training.

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Hendricks, Benjamin K., and Robert F. Spetzler. "Midline Craniotomy for Resection of Cavernous Malformation: 2-Dimensional Operative Video." Operative Neurosurgery 17, no. 6 (November 15, 2019): E239. http://dx.doi.org/10.1093/ons/opz259.

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Abstract This patient presented with a cavernous malformation in the inferior posterior third ventricle extending into the aqueduct. The patient was positioned supine on the operating room table with the head rotated into the horizontal plane. The choroidal fissure is opened lateral to the choroid plexus. This technique allows for the choroid plexus to serve as protection against forniceal manipulation. Rigid retraction was applied to the cerebral falx and corpus callosum to permit aqueductal visualization. The lighted instruments are paramount for adequate visualization of the third ventricle and during dissection of the lesion. Intraoperative visualization and postoperative imaging confirm gross total resection of the lesion. The patient gave informed consent for surgery and video recording. Institutional review board approval was deemed unnecessary. Used with permission from Barrow Neurological Institute.

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Warf, Benjamin C., Sarah Tracy, and John Mugamba. "Long-term outcome for endoscopic third ventriculostomy alone or in combination with choroid plexus cauterization for congenital aqueductal stenosis in African infants." Journal of Neurosurgery: Pediatrics 10, no. 2 (August 2012): 108–11. http://dx.doi.org/10.3171/2012.4.peds1253.

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Object The authors have previously reported on the overall improved efficacy of endoscopic third ventriculostomy (ETV) combined with choroid plexus cauterization (CPC) for infants younger than 1 year of age. In the present study they specifically examined the long-term efficacy of ETV with or without CPC in 35 infants with congenital aqueduct stenosis treated at CURE Children's Hospital of Uganda during the years 2001–2006. Methods Infants with congenital aqueductal stenosis were treated during 2 distinct treatment epochs: all underwent ETV alone, and subsequently all underwent ETV-CPC. Prospectively collected data in the clinical database were reviewed for all infants with an age < 1 year who had been treated for hydrocephalus due to congenital aqueductal stenosis. Study exclusion criteria included: 1) a history or findings on imaging or at the time of ventriculoscopy that suggested a possible infectious cause of the hydrocephalus, including scarred choroid plexus; 2) an open aqueduct or an aqueduct obstructed by a membrane or cyst rather than by stenosis; 3) severe malformations of the cerebral hemispheres including hydranencephaly, significant segments of undeveloped brain, or schizencephaly; 4) myelomeningocele, encephalocele, Dandy-Walker complex, or tumor; or 5) previous shunt insertion. The time to treatment failure was analyzed using the Kaplan-Meier method to construct survival curves. Log-rank (Mantel-Cox) and Gehan-Breslow-Wilcoxon tests were used to determine whether differences between the 2 treatment groups were significant. Results Thirty-five patients met the study criteria. Endoscopic third ventriculostomy alone was performed in 12 patients (mean age 4.7 months), and combined ETV-CPC was performed in 23 patients (mean age 3.5 months). For patients without treatment failure, the mean and median follow-ups were, respectively, 51.6 and 48.0 months in the ETV group and 31.2 and 26.4 months in the ETV-CPC group. Treatment was successful in 48.6% of the patients who underwent ETV alone, as accurately predicted by the Endoscopic Third Ventriculostomy Success Score (ETVSS), and in 81.9% of the patients who underwent ETV-CPC (p = 0.0119, log-rank test; p = 0.0041, Gehan-Breslow-Wilcoxon test; HR 6.42 [95% CI 1.51–27.36]). Conclusions Combined ETV-CPC is significantly superior to ETV alone for infants younger than 1 year of age with congenital aqueductal stenosis. The fact that the outcome for ETV alone was accurately predicted by the ETVSS suggests that these results are applicable in developed countries.

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Kiely, M. J. "Neuroradiology case of the day. Pineal cyst with cerebral aqueduct obstruction." American Journal of Roentgenology 160, no. 6 (June 1993): 1338–39. http://dx.doi.org/10.2214/ajr.160.6.8498257.

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Kolbitsch, Christian, Michael Schocke, Ingo H. Lorenz, Christian Kremser, Fritz Zschiegner, Karl P. Pfeiffer, Stephan Felber, Franz Aichner, Christoph Hormann, and Arnulf Benzer. "Phase-contrast MRI Measurement of Systolic Cerebrospinal Fluid Peak Velocity (CSFVPeak) in the Aqueduct of Sylvius." Anesthesiology 90, no. 6 (June 1, 1999): 1546–50. http://dx.doi.org/10.1097/00000542-199906000-00008.

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Background Cerebrospinal fluid (CSF) outflow to intra- and extracranial subarachnoid spaces caused by arterial inflow to the brain predominantly compensates systolic increases in cerebral blood volume. Phase-contrast magnetic resonance imaging is a new tool for noninvasive assessment of CSF displacement by measuring CSF peak velocity (CSFV(Peak)). The authors tested this new tool in an experimental human model of increased intracranial pressure and reduced cerebral capacity by means of continuous positive airway pressure (CPAP) breathing. Methods The authors investigated systolic CSFV(Peak) in the aqueduct of Sylvius in 11 awake, normocapnic (end-tidal carbon dioxide [ET(CO2)] = 40 mmHg) volunteers without CPAP and at two different CPAP levels (6 and 12 cm H2O) by means of electroencephalography-gated phase-contrast magnetic resonance imaging. Results Administration of 6 cm H2O CPAP did not change systolic CSFV(Peak) (-4.9+/-2.8 cm/s vs. control: -5.1+/-2.7 cm/s), whereas 12 cm H2O CPAP significantly reduced systolic CSFV(Peak) (-4.0+/-1.8 cm/s vs. control: -5.1+/-2.7 cm/s; P < 0.05). Conclusions These findings in awake volunteers show that monitoring CSFV(Peak) in the aqueduct of Sylvius is a sensitive method for detecting even minor impairment of cerebral capacity caused by experimentally induced increases in intracranial pressure.

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Viñals, Fernando, Pilar Ruiz, Gabriel Quiroz, Francisco A. Guerra, Flavia Correa, Daniel Martínez, and Bienvenido Puerto. "Two-Dimensional Ultrasound Evaluation of the Fetal Cerebral Aqueduct: Improving the Antenatal Diagnosis and Counseling of Aqueductal Stenosis." Fetal Diagnosis and Therapy 42, no. 4 (2017): 278–84. http://dx.doi.org/10.1159/000458439.

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Dobrynina, Larisa A., Zukhra Sh Gadzhieva, Kamila V. Shamtieva, Elena I. Kremneva, Bulat M. Akhmetzyanov, Ludmila A. Kalashnikova, and Marina V. Krotenkova. "Microstructural Predictors of Cognitive Impairment in Cerebral Small Vessel Disease and the Conditions of Their Formation." Diagnostics 10, no. 9 (September 19, 2020): 720. http://dx.doi.org/10.3390/diagnostics10090720.

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Introduction: Cerebral small vessel disease (CSVD) is the leading cause of vascular and mixed degenerative cognitive impairment (CI). The variability in the rate of progression of CSVD justifies the search for sensitive predictors of CI. Materials: A total of 74 patients (48 women, average age 60.6 ± 6.9 years) with CSVD and CI of varying severity were examined using 3T MRI. The results of diffusion tensor imaging with a region of interest (ROI) analysis were used to construct a predictive model of CI using binary logistic regression, while phase-contrast magnetic resonance imaging and voxel-based morphometry were used to clarify the conditions for the formation of CI predictors. Results: According to the constructed model, the predictors of CI are axial diffusivity (AD) of the posterior frontal periventricular normal-appearing white matter (pvNAWM), right middle cingulum bundle (CB), and mid-posterior corpus callosum (CC). These predictors showed a significant correlation with the volume of white matter hyperintensity; arterial and venous blood flow, pulsatility index, and aqueduct cerebrospinal fluid (CSF) flow; and surface area of the aqueduct, volume of the lateral ventricles and CSF, and gray matter volume. Conclusion: Disturbances in the AD of pvNAWM, CB, and CC, associated with axonal damage, are a predominant factor in the development of CI in CSVD. The relationship between AD predictors and both blood flow and CSF flow indicates a disturbance in their relationship, while their location near the floor of the lateral ventricle and their link with indicators of internal atrophy, CSF volume, and aqueduct CSF flow suggest the importance of transependymal CSF transudation when these regions are damaged.

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Rangel-Castilla, Leonardo, Jaime Torres-Corzo, Roberto Rodriguez Della Vecchia, Aaron Mohanty, and Haring J. W. Nauta. "Coexistent intraventricular abnormalities in periventricular giant arachnoid cysts." Journal of Neurosurgery: Pediatrics 3, no. 3 (March 2009): 225–31. http://dx.doi.org/10.3171/2008.11.peds08106.

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Object Arachnoid cysts are congenital lesions that arise during development by splitting of the arachnoid membrane. Large cysts can be adjacent to CSF pathways causing a marked midline shift and hydrocephalus. The association between a large arachnoid cyst and hydrocephalus has been commonly described as being due to a mass effect, but these previous reports have not focused closely on any associated intraventricular abnormalities. Methods Seven patients who were previously treated with a cystoperitoneal shunt presented with shunt failure, hydrocephalus, and/or cyst expansion. All of these patients had giant arachnoid cysts extending to the periventricular region from the original site, which was the sylvian fissure in 4 patients, and the suprasellar cistern, quadrigeminal cistern, and interhemispheric fissure in 1 patient each. Endoscopic exploration of the ventricular system and cyst fenestration was then performed in all patients. Results The endoscopic findings were obstruction of the cerebral aqueduct by a membrane not related to the cyst in 5 patients, occlusion of the foramen of Monro in 6, septum pellucidum hypoplasia in 2, and occlusion of the cerebral aqueduct by a quadrigeminal arachnoid cyst in 1. Endoscopic procedures performed were septum pellucidum fenestration and/or foraminoplasty in 5 patients, aqueductoplasty in 2, endoscopic third ventriculostomy in 5, fenestration of the lamina terminalis in 1, and direct cystocisternostomy in 1. After the endoscopic procedure, signs and symptoms of increased intracranial pressure and hydrocephalus improved in all patients, with a reduction in size of the cyst and the ventricle. Conclusions Ventricular abnormalities contributing to hydrocephalus may be associated with arachnoid cysts. These abnormalities may more likely reflect a common origin than a casual relation. Foramen of Monro stenosis and cerebral aqueduct occlusion associated with an arachnoid cyst can be more frequent than has been previously believed. In cases of periventricular giant arachnoid cysts, endoscopic exploration is a good alternative for examining the ventricular system and identifying and treating CSF obstructions caused by and/or related to arachnoid cysts.

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Pramila, Padma John, Pavithra Mannam, Ari George Chacko, and Rohit Ninan Benjamin. "Progressive midbrain clefts after head trauma and decompressive surgery: a report of two patients." BMJ Case Reports 14, no. 2 (February 2021): e238893. http://dx.doi.org/10.1136/bcr-2020-238893.

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This report describes two patients with acute-onset ptosis, oculomotor dysfunction, ataxia and drowsiness, referable to the midbrain tegmentum. Both patients had previously suffered severe closed head injuries requiring craniotomy for cerebral decompression. Serial brain scans in both cases revealed a newly developing cleft in the midbrain, with features suggestive of abnormal cerebrospinal fluid (CSF) flow across the aqueduct. A trial of acetazolamide was initiated to reduce CSF production, followed by a third ventriculostomy for CSF diversion in one patient, which resulted in arrested disease progression and partial recovery. There are only two previous reports in the literature of midbrain clefts that developed as remote sequelae of head trauma. We postulate that altered CSF flow dynamics in the aqueduct, possibly related to changes in brain compliance, may be contributory. Early recognition and treatment may prevent irreversible structural injury and possible death.

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Tan, En-Chow, Takuji Takagi, Seiji Matsuura, and Shiro Mizuno. "Acute obstructive hydrocephalus caused by a migrating intraventricular calculus." Journal of Neurosurgery 78, no. 5 (May 1993): 826–28. http://dx.doi.org/10.3171/jns.1993.78.5.0826.

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✓ A 10-year-old boy presented with acute obstructive hydrocephalus caused by the impaction of a calculus on the cerebral aqueduct. The calculus migrated from the third ventricle to the fourth ventricle after ventricular drainage and right ventriculoperitoneal shunt placement had been performed. The nature and origin of the calculus could not be determined, although its release from the choroid plexus in the lateral ventricle is highly possible.

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Nizhu, Lutfun Nahar, Ahmad Mursel Anam, Shihan Mahmud Redwanul Huq, and Raihan Rabbani. "Obstructive hydrocephalus in a patient with SLE." Bangladesh Journal of Medicine 31, no. 1 (December 30, 2019): 33–36. http://dx.doi.org/10.3329/bjm.v31i1.44751.

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Hydrocephalous is a rare manifestation of systemic lupus erythematosus. Cerebral venous thrombosis, immune complex deposition within the arachnoid villi or direct post-inflammatory lesions of the central nervous system are possible causes of developing acute hydrochephalus. We report a case of acute non-communicating hydrocephalus secondary to stenosis of the aqueduct of Sylvius. The condition developed rapidly in a 22-year-old woman with previously diagnosed SLE. Bangladesh J Medicine Jan 2020; 31(1) : 33-36

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Prakash, Gajendra Singh, and Sukh Mahendra Singh. "RETRACTED ARTICLE: Cyclophosphamide-induced agenesis of cerebral aqueduct resulting in hydrocephalus in mice." Neurosurgical Review 30, no. 3 (April 25, 2007): 245–51. http://dx.doi.org/10.1007/s10143-007-0077-5.

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Meller, S. T., and B. J. Dennis. "A scanning and transmission electron microscopic analysis of the cerebral aqueduct in the rabbit." Anatomical Record 237, no. 1 (September 1993): 124–40. http://dx.doi.org/10.1002/ar.1092370112.

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Goga, Cristina, and Uğur Türe. "The Anterior Transcallosal Approach to a Cerebral Aqueduct Tumor: A 3-Dimensional Operative Video." Operative Neurosurgery 10, no. 3 (September 1, 2014): 492. http://dx.doi.org/10.1227/neu.0000000000000439.

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Bock, A., J. A. Assaf, and R. Geske. "CSF-flow in the cerebral aqueduct: Factors of influence, normative values, CSF-flow disturbance." Clinical Neurophysiology 118, no. 4 (April 2007): e18. http://dx.doi.org/10.1016/j.clinph.2006.11.045.

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Hazama, Ali, Joseph Diver, Benjamin Grannan, Hurmozdiyar Dasenbrock, and Liliana Goumnerova. "Iatrogenic obstructive hydrocephalus resulting from Gelfoam accumulation within the cerebral aqueduct: a case report." Child's Nervous System 34, no. 11 (June 26, 2018): 2333–35. http://dx.doi.org/10.1007/s00381-018-3874-y.

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Tsou, Cheng-Hsien, Yun-Chung Cheng, Chin-Yin Huang, Jeon-Hor Chen, Wen-Hsien Chen, Jyh-Wen Chai, and Clayton Chi-Chang Chen. "Using deep learning convolutional neural networks to automatically perform cerebral aqueduct CSF flow analysis." Journal of Clinical Neuroscience 90 (August 2021): 60–67. http://dx.doi.org/10.1016/j.jocn.2021.05.010.

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Khan, Rihan, Alexander C. Mamourian, and Tarek Radwan. "Utility of multislice computed tomography and reformatted images: identification of migratory intraventricular clot exacerbating obstructive hydrocephalus." Journal of Neurosurgery 109, no. 1 (July 2008): 156–58. http://dx.doi.org/10.3171/jns/2008/109/7/0156.

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Multidetector CT has become widely available and with it the ability to rapidly create detailed reformatted images. Multiplanar images can be created depicting the anatomy in planes other than the traditional axial plane, using isotropic to near-isotropic data. It is important for both clinicians and radiologists to be aware of this capability in order to take advantage of such images. To illustrate the value of this type of imaging, the authors present a case of a third ventricular clot that migrated into the cerebral aqueduct exacerbating hydrocephalus.

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Amadou, A., L. Sonhaye, K. Assih, M. Hemou, D. Kombate, DM D’almeida, Ak Agbangba, G. Wattara, B. N’timon, and K. Adjenou. "Imagerie Des Retars Psychomoteurs De L’enfant A Lome." European Scientific Journal, ESJ 13, no. 27 (September 30, 2017): 258. http://dx.doi.org/10.19044/esj.2017.v13n27p258.

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Objective: To determine by radiology the different etiologies of psychomotor delays (PMD) in Lomé (Togo). Material and Method: Retrospective study of 12 months in the radiology department of CAMPUS Teaching Hospital, concerned images of CT and MRI scans of children 0-16 years of age with PMD. Results: The mean age was 4.4 years +/- 4.35. The result was pathological in 69.63% of the cases.Cerebral atrophy was the most frequent lesion (40.50%), followed by hydrocephalus (23.14%). The congenital stenosis of the Sylvius aqueduct was the most frequent malformation (37.93%). Triventricular hydrocephalus accounted for 45.61% of hydrocephalus. The most common tumor lesions were choroid plexus carcinoma and craniopharyngioma (28.57% each). Meningo-encephalitis accounted for half of infectious cases. Conclusion: PMD is most often the consequence of several cerebral pathologies. The most frequent of which is cerebral atrophy.

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Bakici, C., RO Akgun, D. Ozen, O. Alagin, and C. Oto. "The volume fraction values of the brain compartments using the Cavalieri principle and a 3T MRI in brachycephalic and mesocephalic dogs." Veterinární Medicína 64, No. 11 (November 20, 2019): 482–89. http://dx.doi.org/10.17221/33/2019-vetmed.

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This study was aimed at: 1) estimating the volume and the volume fraction values of brain ventricles, grey matter and white matter with the Cavalieri principle and 2) creating three-dimensional reconstruction models of the brain ventricles by using magnetic resonance imaging. The brain structures of dogs were scanned with a 3T magnetic resonance system. The volumes of the total brain, the grey matter, the white matter, the lateral ventricle, the third ventricle, the cerebral aqueduct and the fourth ventricle of both sides were estimated separately by using a combination of the Cavalieri principle and the point-counting method. In addition to that, magnetic resonance images of dog brains were uploaded to the 3D slicer software to design the three-dimensional reconstruction models. The mean volume fraction values of the left and right lateral ventricle, third ventricle, cerebral aqueduct, and fourth ventricle were 1.83 ± 0.14%, 1.75 ± 0.1%, 0.7 ± 0.07%, 0.2 ± 0.04%, and 1 ± 0.32% for the brachycephalic dogs and 1.69 ± 0.04%, 1.66 ± 0.03%, 0.91 ± 0.03%, 0.27 ± 0.05%, and 0.71 ± 0.15% for the mesocephalic dogs, respectively. There was no statistically significant difference between the brachycephalic and mesocephalic dogs in all the volume fraction values (P > 0.05). This study showed the volume and the volume fraction values of the brain ventricles and the structures in the different types of the dogs’ head shapes. These volume fraction values can be essential data for determining some diseases. Magnetic resonance imaging can be used for precise volume estimations in combination with the Cavalieri principle and the point-counting method.

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Tan, Caroline C., Michael Gonzales, and Alastair Veitch. "CLINICAL IMPLICATIONS OF THE INFRATENTORIAL ROSETTE-FORMING GLIONEURONAL TUMOR." Neurosurgery 63, no. 1 (July 1, 2008): E175—E176. http://dx.doi.org/10.1227/01.neu.0000335085.00718.92.

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ABSTRACT OBJECTIVE This article describes our experience with two patients who presented with unusual tumors in the cerebellar vermis and cerebral aqueduct. Although sparing the fourth ventricle proper, both tumors had histological features consistent with the rare diagnosis of a rosette-forming glioneuronal tumor of the fourth ventricle, of which only 19 cases have been reported previously. A review of the clinical features and courses of all 21 cases is presented and management recommendations are given. CLINICAL PRESENTATION Patient 1 was a 42-year-old man who presented with a headache of 1 day's duration and no neurological signs, in whom magnetic resonance imaging disclosed a nonenhancing mass lesion occupying the proximal cerebral aqueduct. Patient 2 was a 38-year-old woman with a long history of intermittent giddiness, no neurological signs, and a magnetic resonance imaging scan that demonstrated a nonenhancing and subtle abnormality in the cerebellar vermis. INTERVENTION Biopsy was performed on both lesions, the first endoscopically and the second via craniotomy. The only postoperative complication was short-lived double vision and poor upgaze in Patient 1. CONCLUSION These cases demonstrate that the rosette-forming glioneuronal tumor may be more accurately categorized as an infratentorial tumor rather than a tumor of the fourth ventricle. Because the literature indicates that this is a tumor with little potential for malignant behavior and considerable morbidity can accompany attempts at resection, a conservative management approach would seem well advised. If this tumor is to be managed conservatively, because of the paucity of extended follow-up data, long-term radiological and clinical surveillance is strongly recommended.

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da Costa, André Corsino, Nilson Pinheiro Júnior, Clecio Godeiro Junior, Ana Clara Aragão Fernandes, Cítara Trindade de Queiroz, Anaís Concepcion Marinho Andrade de Moura, Carlos Eduardo França de Aquino, and Marianne de Araújo Rego. "Parkinsonism secondary to ventriculoperitoneal shunt in a patient with hydrocephalus." Surgical Neurology International 12 (August 30, 2021): 432. http://dx.doi.org/10.25259/sni_629_2021.

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Background: Parkinsonism secondary to the treatment of obstructive hydrocephalus due to stenosis of the cerebral aqueduct, with implantation of a ventricular peritoneal (VP) shunt is a rare complication, still poorly described and disseminated in the literature. Case Description: A 38-year-old male presented a history of moderate-intensity daily headache, which deteriorated 2 months before admission, with no changes in the neurological examination. Magnetic resonance imaging showed hypertensive hydrocephalus associated with cerebral aqueduct stenosis. A VP shunt was performed, an adjustable pressure valve was successfully inserted, and he was discharged asymptomatic. However, months later, he progressed with important symptoms of hypo- and hyper-drainage, which persisted after valve pressure adjustments and even its exchange, culminating into an endoscopic third ventriculostomy (ETV). But soon after, severe Parkinsonian syndrome appeared. Therapy with levodopa and bromocriptine was initiated, revealing a slow response initially but good evolution within 6 months. At present, he presents low-intensity residual tremor, which is well controlled with medications, and has regained independence for daily activities, with minimal motor limitation and no cognitive changes. Conclusion: There is still no mechanism that explains the occurrence of Parkinsonian syndrome in these cases. It is suggested that the rostral portion of the midbrain was injured due to abrupt changes in the transtentorial gradient pressure after the ventricular shunt, along with various adjustments in the valve pressure. ETV and early introduction of levodopa therapy in patients who developed postventriculoperitoneal shunt Parkinsonism seems to be the most effective combination, with satisfactory clinical response in the medium/long term.

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McCoy, M. R., F. Klausner, F. Weymayr, L. Georg, E. Broussalis, S. M. Golaszewski, S. Emich, J. Steinbacher, and A. R. Al-Shameri. "Aqueductal flow of cerebrospinal fluid (CSF) and anatomical configuration of the cerebral aqueduct (AC) in patients with communicating hydrocephalus—The trumpet sign." European Journal of Radiology 82, no. 4 (April 2013): 664–70. http://dx.doi.org/10.1016/j.ejrad.2012.11.032.

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Journal articles on the topic 'Cerebral aqueduct'

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