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

Radoš, Milan and Orešković, Darko and Radoš, Marko and Jurjević, Ivana and Klarica, Marijan (2014) Long lasting near-obstruction stenosis of mesencephalic aqueduct without development of hydrocephalus - case report. Croatian Medical Journal, 55 (4). pp. 394-398. ISSN 0353-9504

PDF - Published Version
Download (479kB) | Preview


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.

Item Type: Article
MeSH: Adult ; Cerebral Aqueduct / pathology ; Constriction, Pathologic / etiology ; Cysts / complications ; Female ; Humans ; Hydrocephalus / physiopathology ; Incidental Findings ; Magnetic Resonance Imaging ; Pineal Gland
Departments: Katedra za farmakologiju
Katedra za radiologiju i opću kliničku onkologiju
Depositing User: Marijan Šember
Status: Published
Orešković, DarkoUNSPECIFIED
Jurjević, IvanaUNSPECIFIED
Klarica, MarijanUNSPECIFIED
Date: 28 August 2014
Date Deposited: 30 Sep 2014 15:11
Last Modified: 17 Jul 2020 10:30
Subjects: /
Related URLs:
URI: http://medlib.mef.hr/id/eprint/2154

Actions (login required)

View Item View Item


Downloads per month over past year