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[A case of disproportionately large communicating fourth ventricle (DLCFV) combined with syringomyelia and Chiari malformation].
No Shinkei Geka. 1991 Feb; 19(2):167-72.NS

Abstract

We report a rare case of disproportionately large communicating fourth ventricle (DLCFV) combined with syringomyelia and Chiari malformation. The case was a 27-year-old male who underwent ventriculoperitoneal (V-P) shunt on the right side for hydrocephalus caused by traumatic intracerebral and intraventricular hemorrhage. One month later, he became somnolent with posterior fossa symptoms (nausea, vomiting and nystagmus). CT scan demonstrated enlarged fourth ventricle, which was diagnosed as DLCFV because the ventriculogram revealed patency of the aqueduct. One and half month later a second V-P shunt was made on the left side to increase the shunt flow. He became ambulatory with a cane, although the fourth ventricle remained moderately dilated on CT scan. Two months after the additional V-P shunt, he slipped and hit the occiput and immediately became tetraparetic. The patient was treated conservatively under the diagnosis of central spinal cord injury. The MRI taken 2 months after the accident revealed Chiari malformation (type 1), syringomyelia and a dilated fourth ventricle which was compressing the brainstem. After the fourth ventriculoperitoneal (FV-P) shunt, the tetraparesis transiently improved but then again worsened. On the CT scan the syrinx did non change in size, while the size of the fourth ventricle became normal. After syringoperitoneal (S-P) shunt the patient showed a moderate improvement of tetraparesis. Unfortunately he suffered appendicitis complicated with peritonitis and all the shunts were immediately changed to external drainage. However, the patient developed meningitis and became paraplegic. The motor function of the upper extremities slightly improved by aspiration of fluid via the external drainage system from the syrinx.(ABSTRACT TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Toriyama T
Division of Neurosurgery, Komoro Kosei General Hospital, Japan.
Kawauchi M
No affiliation info available
Koike J
No affiliation info available
Harada T
No affiliation info available
Murata A
No affiliation info available
Kyoshima K
No affiliation info available

MeSH

AdultBrain DiseasesBudd-Chiari SyndromeCerebral VentriclesCerebrospinal Fluid ShuntsHumansMalePeritoneal CavitySyringomyelia

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

jpn

PubMed ID

2023674

Citation

Toriyama, T, et al. "[A Case of Disproportionately Large Communicating Fourth Ventricle (DLCFV) Combined With Syringomyelia and Chiari Malformation]." No Shinkei Geka. Neurological Surgery, vol. 19, no. 2, 1991, pp. 167-72.
Toriyama T, Kawauchi M, Koike J, et al. [A case of disproportionately large communicating fourth ventricle (DLCFV) combined with syringomyelia and Chiari malformation]. No Shinkei Geka. 1991;19(2):167-72.
Toriyama, T., Kawauchi, M., Koike, J., Harada, T., Murata, A., & Kyoshima, K. (1991). [A case of disproportionately large communicating fourth ventricle (DLCFV) combined with syringomyelia and Chiari malformation]. No Shinkei Geka. Neurological Surgery, 19(2), 167-72.
Toriyama T, et al. [A Case of Disproportionately Large Communicating Fourth Ventricle (DLCFV) Combined With Syringomyelia and Chiari Malformation]. No Shinkei Geka. 1991;19(2):167-72. PubMed PMID: 2023674.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [A case of disproportionately large communicating fourth ventricle (DLCFV) combined with syringomyelia and Chiari malformation]. AU - Toriyama,T, AU - Kawauchi,M, AU - Koike,J, AU - Harada,T, AU - Murata,A, AU - Kyoshima,K, PY - 1991/2/1/pubmed PY - 1991/2/1/medline PY - 1991/2/1/entrez SP - 167 EP - 72 JF - No shinkei geka. Neurological surgery JO - No Shinkei Geka VL - 19 IS - 2 N2 - We report a rare case of disproportionately large communicating fourth ventricle (DLCFV) combined with syringomyelia and Chiari malformation. The case was a 27-year-old male who underwent ventriculoperitoneal (V-P) shunt on the right side for hydrocephalus caused by traumatic intracerebral and intraventricular hemorrhage. One month later, he became somnolent with posterior fossa symptoms (nausea, vomiting and nystagmus). CT scan demonstrated enlarged fourth ventricle, which was diagnosed as DLCFV because the ventriculogram revealed patency of the aqueduct. One and half month later a second V-P shunt was made on the left side to increase the shunt flow. He became ambulatory with a cane, although the fourth ventricle remained moderately dilated on CT scan. Two months after the additional V-P shunt, he slipped and hit the occiput and immediately became tetraparetic. The patient was treated conservatively under the diagnosis of central spinal cord injury. The MRI taken 2 months after the accident revealed Chiari malformation (type 1), syringomyelia and a dilated fourth ventricle which was compressing the brainstem. After the fourth ventriculoperitoneal (FV-P) shunt, the tetraparesis transiently improved but then again worsened. On the CT scan the syrinx did non change in size, while the size of the fourth ventricle became normal. After syringoperitoneal (S-P) shunt the patient showed a moderate improvement of tetraparesis. Unfortunately he suffered appendicitis complicated with peritonitis and all the shunts were immediately changed to external drainage. However, the patient developed meningitis and became paraplegic. The motor function of the upper extremities slightly improved by aspiration of fluid via the external drainage system from the syrinx.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0301-2603 UR - https://www.unboundmedicine.com/medline/citation/2023674/[A_case_of_disproportionately_large_communicating_fourth_ventricle__DLCFV__combined_with_syringomyelia_and_Chiari_malformation]_ DB - PRIME DP - Unbound Medicine ER -