open access

Vol 7, No 1 (2004)
Published online: 2004-01-22
Submitted: 2012-01-23
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Radionuclide cisternography in diagnostics of obstruction hydrocephalus in introduced ventriculoperitoneal shunt

Irena Cernochova, Radim Lipina
Nucl. Med. Rev 2004;7(1):85-86.

open access

Vol 7, No 1 (2004)
Published online: 2004-01-22
Submitted: 2012-01-23

Abstract

BACKGROUND: To confirm or exclude a diagnosis of internal obstruction hydrocephalus in an 8-year old girl with an introduced ventriculoperitoneal (V-P) shunt.
CASE REPORT: Establishing the V-P shunt is indisputably the route of choice in non-communicating hydrocephalus. The existence of a V-P shunt, however, is connected with numerous risks, especially of injuries, infection as well as increased intraabdominal pressure - e.g. in pregnancy. The development of endoscopy in neurosurgery allows the creation of communication via the bottom of the third ventricle with basal cisterns, and the subsequent cancellation of a V-P shunt.
MATERIAL AND METHODS: We describe the case of an 8-year old girl with congenital internal hydrocephalus with an assumed obliteration of the Sylvian aqueduct with an established V-P shunt. An MR scan described the membrane in the area of the Sylvian aqueduct, but the disproportion between the dilatation of the lateral ventricles, third ventricle and fourth ventricle led the physician to doubt as to the accuracy of the diagnosis of internal obstruction hydrocephalus. Therefore we performed a radionuclide cisternography (in a modified manner), which proved an existing communication between the third and fourth cerebral ventricle and which contradicted the clinical diagnosis of obstruction hydrocephalus.

Abstract

BACKGROUND: To confirm or exclude a diagnosis of internal obstruction hydrocephalus in an 8-year old girl with an introduced ventriculoperitoneal (V-P) shunt.
CASE REPORT: Establishing the V-P shunt is indisputably the route of choice in non-communicating hydrocephalus. The existence of a V-P shunt, however, is connected with numerous risks, especially of injuries, infection as well as increased intraabdominal pressure - e.g. in pregnancy. The development of endoscopy in neurosurgery allows the creation of communication via the bottom of the third ventricle with basal cisterns, and the subsequent cancellation of a V-P shunt.
MATERIAL AND METHODS: We describe the case of an 8-year old girl with congenital internal hydrocephalus with an assumed obliteration of the Sylvian aqueduct with an established V-P shunt. An MR scan described the membrane in the area of the Sylvian aqueduct, but the disproportion between the dilatation of the lateral ventricles, third ventricle and fourth ventricle led the physician to doubt as to the accuracy of the diagnosis of internal obstruction hydrocephalus. Therefore we performed a radionuclide cisternography (in a modified manner), which proved an existing communication between the third and fourth cerebral ventricle and which contradicted the clinical diagnosis of obstruction hydrocephalus.
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Keywords

congenital internal hydrocephalus; V-P shunt; MR; 111In-DTPA cisternography

About this article
Title

Radionuclide cisternography in diagnostics of obstruction hydrocephalus in introduced ventriculoperitoneal shunt

Journal

Nuclear Medicine Review

Issue

Vol 7, No 1 (2004)

Pages

85-86

Published online

2004-01-22

Bibliographic record

Nucl. Med. Rev 2004;7(1):85-86.

Keywords

congenital internal hydrocephalus
V-P shunt
MR
111In-DTPA cisternography

Authors

Irena Cernochova
Radim Lipina

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