Endoscopic observation and septostomy is effective for unilateral hydrocephalus without obvious obstruction of foramen of Monro: a case report

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  • 明らかなMonro孔閉塞を伴わない片側性水頭症に対して神経内視鏡治療を行った1例

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Abstract

<p>Unilateral hydrocephalus (a situation whereby one lateral ventricle is dilated) is a relatively rare condition. Many cases result from morphological obstruction of the foramen of Monro (congenital atresia, tumor, cyst, etc.) or membranous obstruction of the foramen of Monro (inflammation due to infection or hemorrhage). However, we report a case of a 4-year-old boy who presented with unilateral hydrocephalus without an obvious obstruction of the foramen of Monro. It was discovered accidentally while exploring the cause of optic disc edema. We performed a neuroendoscopic exploration before surgery because of the unilateral hydrocephalus caused by a membranous obstruction of the foramen of Monro. However, neuroendoscopic observation revealed stenosis of the foramen of Monro, covered by the choroid plexus, suggesting some check valve function. After endoscopic septostomy, there was a marked dilatation of one lateral ventricle and relieve of the optic disc edema. In this case, we demonstrated the pathophysiology of unilateral hydrocephalus and the usefulness of endoscopic treatment.</p>

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