Angiographic diagnosis of non-neoplastic aqueductal stenosis in children
Okudera, T.; Takahashi, M.
No Shinkei Geka. Neurological Surgery 4(1): 43-55
1976
ISSN/ISBN: 0301-2603 PMID: 1082994 Document Number: 106358
Angiograpic diagnosis of non-neoplastic aqueductal stenosis in 4 children were described. The materials were selected from 160 vertebral angiograms of children below 15 years, performed at the Kyushu University Hospital from July 1967 to March 1974. There were 4 cases of angiographically demonstrated non-neoplastic aqueductal stenosis. These cases were confirmed by pneumoence-phalogram and/or pneumoventriculograms, which were performed before and after the Tolkildens procedure. Ages of the patients varied from 6 to 15 years with average of 11.8 years. All the angiographic findings of these 4 patients with non-neoplastic aqueductal stenosis were explained on the basis of 5 major morphological changes such as 1) marked symmetrical obstructive hydrocephalus, 2) dilatation of the third ventricle and aqueduct above the obstruction with resultant downward displacement and compression up the upper brain stem and posterior displacement of the precentral cerebellar fissure, 3) maintenance of normal shape and position of the lower half of the posterior fossa structure, 4) absence of midline shaft of the median and paramedian vessels, 5) morphologic changes of the subarachonoid cisterns. These angiographic findings coincided with the angiographic features as described by Huang et al. (1968), under the experience with 10 cases of non-neoplastic aqueductal stenosis of adults, averaging of 43 years. Special emphasis was placed on the diagnostic value of the small veins and arteries in the posterior fossa vascular system. We also emphasized that the vertebral angiography should be performed as the first investigative procedure using the contrast media in the posterior fossa lesions.