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“Disproportionately Large, Communicating Fourth Ventricle” due to Membranous Obstruction of Magendie's Foramen Yasuhiko OSAKA 1,2 , Hiroshi SHIN 1 , Noriaki SUGAWA 1 , Eiji YOSHINO 1 , Yoshiharu HORIKAWA 1 , Tarumi YAMAKI 1 , Satoshi UEDA 1 1Department of Neurosurgery, Kyoto Prefectural University of Medicine Keyword: Hydrocephalus , Magendie's foramen , MRI pp.429-433
Published Date 1995/5/10
DOI https://doi.org/10.11477/mf.1436901022
  • Abstract
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A case of disproportionately large, communicating fourth ventricle (DLCFV) with the entire ventricular system dilated symmetrically due to membranous ob-struction of Magendie's foramen is reported. A 20-year-old female complained of headache and nausea. Slight papilledema was found in both eyes. CT scan and MRI showed that the entire ventricular system was dilated symmetrically, but we could not locate the cause of this disease, for example, tumor, arachnoid cyst, cerebellar malformation and so on. Although cinemode-MRI showed CSF pulsation as if CSF flowed through Magendie's foramen, we were not convinced that CSF flowed through it. We speculated that something ob-structed CSF flow at Magendie's or Luschka's foramen, so surgery was performed by suhoccipital craniectomy.As expected, a mombranous obstruction was found at Magendie's foramen. After excision of the membrane, all symptoms improved. Postoperative cinemode-MRI clearly demonstrated CSF flow through Magenclie's foramen.

Ventriculoperitoneal shunting is generally effective for DLCFV, but we do not consider it the optimal treatment. The cause of DLCFV must be confirmed by suboccipital craniectomy if evidence of NPH, mass le-sion or cerebellar malformation cannot be found any-where especially around Magendie's foramen.


Copyright © 1995, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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