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Child's Nervous System
Published in: Child's Nervous System 4/2016

01-04-2016 | Case Report

Bilateral occlusion of the foramina of Monro after endoscopic third ventriculostomy for aqueductal stenosis—a case report

Authors: Yuichi Nagata, Kazuhito Takeuchi, Tetsuya Nagatani, Tadashi Watanabe, Yusuke Sato, Masao Tambara, Toshihiko Wakabayashi

Published in: Child's Nervous System | Issue 4/2016

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Abstract

Case report

Bilateral occlusion of the foramina of Monro is an extremely rare clinical condition. We present the case of a 10-year-old girl who complained of frequent headaches.

Methods

Magnetic resonance imaging showed triventricular hydrocephalus due to aqueductal stenosis, so endoscopic third ventriculostomy was performed successfully. The headaches subsequently disappeared, but the patient presented with exacerbation of headaches 32 months postoperatively. Magnetic resonance imaging demonstrated bilateral hydrocephalus of the lateral ventricles, implying bilateral occlusion of the foramina of Monro. We again performed endoscopic surgery, confirming bilateral occlusion of the foramina of Monro.

Results

The foramina of Monro were apparently obstructed by normal ependyma, and no tumor masses or other structures were detected around the foramina, so we diagnosed the occlusion of the foramina as secondary after endoscopic third ventriculostomy. We fenestrated the septum pellucidum using a monopolar micro endoscopic electrode, and a ventriculoperitoneal shunt was placed for the management of hydrocephalus. The postoperative course was uneventful, and the headaches were completely resolved.
Literature
1.
Black P, Levine B, Picard E, Nirmel K (1983) Asymmetrical hydrocephalus following ventriculitis from rupture of a thalamic abscess. Surg Neurol 19:524–527CrossRefPubMed
2.
Bouras T, Sgouros S (2011) Complications of endoscopic third ventriculostomy. J Neurosurg Pediatr 7:643–649CrossRefPubMed
3.
De Bonis P, Anile C, Tamburrini G, Tartaglione T, Mangiola A (2008) Adult idiopathic occlusion of the foramina of Monro: diagnostic tools and therapy. J Neuroimaging 18:101–104CrossRefPubMed
4.
de Ribaupierre S, Rilliet B, Vernet O, Regli L, Villemure JG (2007) Third ventriculostomy vs ventriculoperitoneal shunt in pediatric obstructive hydrocephalus: results from a Swiss series and literature review. Childs Nerv Syst 23:527–533CrossRefPubMed
5.
Drake JM, Kulkarni AV, Kestle J (2009) Endoscopic third ventriculostomy versus ventriculoperitoneal shunt in pediatric patients: a decision analysis. Childs Nerv Syst 25:467–472CrossRefPubMed
6.
El Refaee E, Baldauf J, Schroeder HW (2012) Bilateral occlusion of the foramina of Monro after third ventriculostomy. J Neurosurg 116:1333–1336CrossRefPubMed
7.
Freudenstein D, Duffner F, Krapf H, Wagner A, Grote EH (2002) Neuroendoscopic treatment of idiopathic occlusion of the foramen of Monro in adults. Neurol Med Chir (Tokyo) 42:81–85CrossRef
8.
Hamada H, Hayashi N, Kurimoto M, Umemura K, Hirashima Y, Endo S (2003) Neuroendoscopic septostomy for isolated lateral ventricle. Neurol Med Chir (Tokyo) 43:582–588CrossRef
9.
Kalhorn SP, Strom RG, Harter DH (2011) Idiopathic bilateral stenosis of the foramina of Monro treated using endoscopic foraminoplasty and septostomy. Neurosurg Focus 30(4), E5CrossRefPubMed
10.
Milhorat TH, Hammock MK, Breckbill DL (1975) Acute unilateral hydrocephalus resulting from oedematous occlusion of foramen of Monro: complication of intraventricular surgery. J Neurol Neurosurg Psychiatry 38:745–748CrossRefPubMedPubMedCentral
11.
Mori H, Koike T, Fujimoto T, Nishiyama K, Yoshimura J, Tanaka R (2007) Endoscopic stent placement for treatment of secondary bilateral occlusion of the Monro foramina following endoscopic third ventriculostomy in a patient with aqueductal stenosis. Case report. J Neurosurg 107:416–420CrossRefPubMed
12.
Oi S, Enchev Y (2008) Neuroendoscopic foraminal plasty of foramen of Monro. Childs Nerv Syst 24:933–942CrossRefPubMed
13.
Oi S, Matsumoto S (1985) Pathophysiology of nonneoplastic obstruction of the foramen of Monro and progressive unilateral hydrocephalus. Neurosurgery 17:891–896CrossRefPubMed
14.
Oi S, Yamada H, Sasaki K, Matsumoto S (1985) Atresia of the foramen of Monro resulting in severe unilateral hydrocephalus with subfalcial herniation and infratentorial diverticulum. Neurosurgery 16:103–106CrossRefPubMed
15.
Schroeder HW, Oertel J, Gaab MR (2004) Incidence of complications in neuroendoscopic surgery. Childs Nerv Syst 20:878–883CrossRefPubMed
16.
Sharifi G, Alavi E, Rezaee O, Jahanbakhshi A, Faramarzi F (2012) Neuroendoscopic foraminoplasty for bilateral idiopathic occlusion of foramina of Monro. Turk Neurosurg 22(2):265–268PubMed
17.
Tien R, Harsh GR IV, Dillon WP, Wilson CB (1990) Unilateral hydrocephalus caused by an intraventricular venous malformation obstructing the foramen of Monro. Neurosurgery 26:664–666CrossRefPubMed
18.
Wong TT, Lee LS (2000) Membranous occlusion of the foramen of Monro following ventriculoperitoneal shunt insertion: a role for endoscopic foraminoplasty. Childs Nerv Syst 16:213–217CrossRefPubMed
Metadata
Title
Bilateral occlusion of the foramina of Monro after endoscopic third ventriculostomy for aqueductal stenosis—a case report
Authors
Yuichi Nagata
Kazuhito Takeuchi
Tetsuya Nagatani
Tadashi Watanabe
Yusuke Sato
Masao Tambara
Toshihiko Wakabayashi
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 4/2016
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-015-2913-1

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