Long lasting near-obstruction stenosis of mesencephalic aqueduct without development of hydrocephalus - case report

Scientific paper - Case study

• Author: Milan Radoš
• Author: Darko Orešković
• Author: Marko Radoš
• Author: Ivana Jurjević
• Author: Marijan Klarica
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

The aim of this study is to present the five-year longitudinal magnetic resonance imaging (MRI) follow up of a patient with incidental finding of near-obstruction stenosis of the aqueduct of Sylvius due to a large pineal cyst. The patient was scanned 3 times on a 3T MR device using a set of standard structural sequences supplemented with high-resolution constructive interference of steady state (CISS) T2 sequence for precise delineation of the aqueduct of Sylvius and cardiac-gated phase-contrast sequences for the analysis of cerebrospinal fluid (CSF) movement. On all MR scans, the size of the pineal cyst and severity of near-obstruction aqueductal stenosis did not show any morphological changes. There was no significant ventricular enlargement although structural CISS sequence showed a near-obstruction stenosis and cardiac-gated phase-contrast sequences did not detect CSF movement through the aqueduct of Sylvius. Our findings are contradictory to the classic hypothesis of CSF physiology based on secretion, circulation, and absorption of CSF, which states that the impairment of CSF circulation through the aqueduct of Sylvius inevitably leads to a hypertensive hydrocephalus development involving the third and the lateral ventricle. Our research group previously proposed a new hypothesis of CSF physiology, which offers more suitable explanation for such clinical cases.

• Keywords (english): Adult; Cerebral Aqueduct / pathology; Constriction, Pathologic / etiology; Cysts / complications; Female; Humans; Hydrocephalus / physiopathology; Incidental Findings; Magnetic Resonance Imaging; Pineal Gland
• Language: english
• Publication type: Scientific paper - Case study
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Croatian Medical Journal
• Numbering: vol. 55, no. 4, pp. 394-398
• p-ISSN: 0353-9504
• DOI: https://doi.org/10.3325/cmj.2014.55.394
• URN:NBN: urn:nbn:hr:105:822017
• Publication: 2014-08-28
• Document URL: https://doi.org/10.3325/cmj.2014.55.394
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-27 20:09:40