Case report, case study
https://doi.org/10.3325/cmj.2021.62.411
The role of mesencephalic aqueduct obstruction in hydrocephalus development: a case report
Milan Radoš
; Croatian Institute for Brain Research, Zagreb University School of Medicine, Zagreb, Croatia
Darko Orešković
; Department of Molecular Biology, Ruđer Bošković Institute, Zagreb, Croatia
Marijan Klarica
; Croatian Institute for Brain Research, Zagreb University School of Medicine, Zagreb, Croatia
Abstract
We report on three patients with mesencephalic aqueduct obstruction, which completely blocked the cerebrospinal fluid communication between the third and fourth
cerebral ventricle, demonstrated by standard and highresolution magnetic resonance sequences. Only one patient developed radiological and clinical presentation of
hydrocephalus, without radiological signs of increased
intraventricular pressure. The remaining two patients did
not show clinical signs of hydrocephalus and had a normal
radiological presentation of the ventricular system. These
findings contradict the classical concept of cerebrospinal
fluid physiology. This concept assumes a unidirectional circulation of cerebrospinal fluid through the mesencephalic aqueduct from the secretion site, predominantly in the
choroid plexuses, to the resorption site, predominantly in
the dural venous sinuses. Therefore, the obstruction of the
mesencephalic aqueduct would inevitably lead to triventricular hypertensive hydrocephalus in all patients. The current observations, however, accord with the new concept
of cerebrospinal fluid physiology, which postulates that
cerebrospinal fluid does not circulate unidirectionally because it is both formed and resorbed along the entire capillary network within the central nervous system
Keywords
Hrčak ID:
278454
URI
Publication date:
26.8.2021.
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