Due to the suspicion of aqueduct stenosis and concerns about the patient's baseline elevation of CPK level (5,055 unit/L), the decision was made to treat with an ETV and CPC over placement of a ventriculoperitoneal shunt.
We had high suspicion of aqueduct stenosis on the MRI study, supporting our plan to achieve success utilizing ETV along with CPC.
Since the indications for ETV are not only permanently increasing, but also constantly adjusting and getting re-tailored [1,2], they nowadays, apart from cerebral aqueduct stenosis
, includes many clinical conditions with underlying disturbance of cerebrospinal fluid (CSF) hydrodynamics, such as in patients with posterior fossa tumors and cysts , communicating hydrocephalus , normal pressure hydrocephalus , and in patients with previous ventriculoperitoneal shunts failure , but lately also in the hydrocephalic patients with achondroplasia .
There were 15 patients with congenital aqueduct stenosis
, 15 patients with posthemorrhagic hydrocephalus, 7 patients with postinfectious hydrocephalus, and 5 patients with Chiari malformation associated hydrocephalus in our group.
The most common cause of IVOH is aqueduct stenosis
or blockage between the third and fourth ventricles, and this type of stenosis is known as the Dandy-Walker malformation. The condition usually is congenital.