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Syringomyelia with obstructive hydrocephalus at the foramens of Luschka and Magendie successfully treated by endoscopic third ventriculostomy.
Surg Neurol. 2009 Mar; 71(3):349-52, discussion 352.SN

Abstract

BACKGROUND

Syringomyelia rarely accompanies hydrocephalus except for the cases with Chiari malformation, and the efficacy of endoscopic third ventriculostomy for this entity is undetermined.

CASE REPORT

A 55-year-old man developed sensory disturbance and discrete movement disturbance on the bilateral upper limb during the past 3 years. On admission, he presented with slight tetraparesis and hyperreflection on his lower limbs with rectovesical dysfunction. Preoperative MR imaging demonstrated marked enlargement of the lateral ventricles as well as the third and fourth ventricle due to obstruction of the foramens of Luschka and Magendie. Spine MR imaging showed longitudinal dilatation of the central canal from the cerebrospinal junction toward the thoracic level with communication to the fourth ventricle, whereas Chiari malformation and tight cisterna magna were absent. He was successfully treated by ETV. The patient significantly recovered from his symptoms postoperatively, and MR imaging after surgery showed apparent shrinkage of the syrinx as well as the ventricles.

CONCLUSION

The efficacy of the normalization of cerebrospinal fluid circulation and subsequent improvement of the syringomyelia in the present case may suggest that ETV could be a therapeutic choice for syringomyelia associated with hydrocephalus due to the obstruction of the foramens of Luschka and Magendie, especially when the connection between the ventricular system and the dilated central canal is evident, and may give a clue to the explanation for Gardner's hydrodynamic theory.

Authors+Show Affiliations

Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan.No affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

18207547

Citation

Kawaguchi, Tomohiro, et al. "Syringomyelia With Obstructive Hydrocephalus at the Foramens of Luschka and Magendie Successfully Treated By Endoscopic Third Ventriculostomy." Surgical Neurology, vol. 71, no. 3, 2009, pp. 349-52, discussion 352.
Kawaguchi T, Fujimura M, Tominaga T. Syringomyelia with obstructive hydrocephalus at the foramens of Luschka and Magendie successfully treated by endoscopic third ventriculostomy. Surg Neurol. 2009;71(3):349-52, discussion 352.
Kawaguchi, T., Fujimura, M., & Tominaga, T. (2009). Syringomyelia with obstructive hydrocephalus at the foramens of Luschka and Magendie successfully treated by endoscopic third ventriculostomy. Surgical Neurology, 71(3), 349-52, discussion 352. https://doi.org/10.1016/j.surneu.2007.08.015
Kawaguchi T, Fujimura M, Tominaga T. Syringomyelia With Obstructive Hydrocephalus at the Foramens of Luschka and Magendie Successfully Treated By Endoscopic Third Ventriculostomy. Surg Neurol. 2009;71(3):349-52, discussion 352. PubMed PMID: 18207547.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Syringomyelia with obstructive hydrocephalus at the foramens of Luschka and Magendie successfully treated by endoscopic third ventriculostomy. AU - Kawaguchi,Tomohiro, AU - Fujimura,Miki, AU - Tominaga,Teiji, Y1 - 2008/01/22/ PY - 2007/07/18/received PY - 2007/08/02/accepted PY - 2008/1/22/pubmed PY - 2009/5/12/medline PY - 2008/1/22/entrez SP - 349-52, discussion 352 JF - Surgical neurology JO - Surg Neurol VL - 71 IS - 3 N2 - BACKGROUND: Syringomyelia rarely accompanies hydrocephalus except for the cases with Chiari malformation, and the efficacy of endoscopic third ventriculostomy for this entity is undetermined. CASE REPORT: A 55-year-old man developed sensory disturbance and discrete movement disturbance on the bilateral upper limb during the past 3 years. On admission, he presented with slight tetraparesis and hyperreflection on his lower limbs with rectovesical dysfunction. Preoperative MR imaging demonstrated marked enlargement of the lateral ventricles as well as the third and fourth ventricle due to obstruction of the foramens of Luschka and Magendie. Spine MR imaging showed longitudinal dilatation of the central canal from the cerebrospinal junction toward the thoracic level with communication to the fourth ventricle, whereas Chiari malformation and tight cisterna magna were absent. He was successfully treated by ETV. The patient significantly recovered from his symptoms postoperatively, and MR imaging after surgery showed apparent shrinkage of the syrinx as well as the ventricles. CONCLUSION: The efficacy of the normalization of cerebrospinal fluid circulation and subsequent improvement of the syringomyelia in the present case may suggest that ETV could be a therapeutic choice for syringomyelia associated with hydrocephalus due to the obstruction of the foramens of Luschka and Magendie, especially when the connection between the ventricular system and the dilated central canal is evident, and may give a clue to the explanation for Gardner's hydrodynamic theory. SN - 0090-3019 UR - https://www.unboundmedicine.com/medline/citation/18207547/Syringomyelia_with_obstructive_hydrocephalus_at_the_foramens_of_Luschka_and_Magendie_successfully_treated_by_endoscopic_third_ventriculostomy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-3019(07)00964-0 DB - PRIME DP - Unbound Medicine ER -