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Obstructive Hydrocephalus (at level of Sylvian aqueduct)

USU Teaching File MUTF - MedPix

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Obstructive Hydrocephalus (at level of Sylvian aqueduct)

History: Pt is a 10 y/o bright male with a h/o developmental tremor and some degree of gait asymmetry/ right toe flat walking with a short h/o new onset severe headache with associated loss of balance leading to fall, no LOC. Previous hx unknown.

Findings: Symmetric severe dilation of the third and lateral ventricles. Fourth ventricle is of normal size and contour. There is obliteration of Sylvian aqueduct by an enlarged and convex portion of the superior tectal plate. There is no reliable evidence of parenchymal enhancement here or otherwise. There is a linear increased FLAIR signal noted around the lateral ventricles suggestive of transependymal pressure or CSF flow. The orbits, skull base and pituitary fossa are all WNL. Normal intracranial flow void seen

Ddx: Obstructive hydrocephalus resulting from stenosis at the aqueduct of Sylvius. Although the stenosis may be congenital the images suggest a low grade neoplasm of the tectal plate.

Dxhow: Imaging diagnosis

Exam: GEN: WNWD. Mental Status: awake, responsive, alert and oriented X 3. Head/Neck: normocephalic, supple without masses. Eyes: See neuro exam. Ears Clear TM’s, normal canals. Nose/Sinuses: Normal. Throat/Mouth/Teeth: Normal. Chest/Lungs: Equal BS, no rales, ronchi, wheezes or rubs. Heart: No gallops, rubs or murmurs. Abdomen: Soft, nontender, normal BS, no organomegaly. Male genitalia: Normal phallus, bilaterally descended testes with normal size, position, and consistency, no inguinal hernia. Back: Nornal. Neuro: Bright, articulate, inquisitive, fluent speech, excellent math and recall Reflexes symmetric, no pathologic reflexes EOMI, PERRL, bilat papilladema, ou 20/20, face symmetry, gag symmetry, corneal reflex intact Mild hypesthesia in right face. No pronator drift, symmetric strength Bilat UE intention tremor, dysmetria, and dysdiadochokinesis Bilat LE normal gait, no dysmetria, normal tandem walk Extremeties: no clubbing, cyanosis or edema. Skin: No lesions, no petechiae, no decubiti

No MeSH data available.


Symmetric severe dilation of the third and lateral ventricles.  Fourth ventricle is of normal size and contour.  There is obliteration of Sylvian aqueduct by an enlarged and convex portion of the superior tectal plate.   There is no reliable evidence of parenchymal enhancement here or otherwise.  There is a linear increased FLAIR signal noted around the lateral ventricles suggestive of transependymal pressure or CSF flow.  The orbits, skull base and pituitary fossa are all WNL.  Normal intracranial flow void seen.
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MPX1410_synpic19205: Symmetric severe dilation of the third and lateral ventricles. Fourth ventricle is of normal size and contour. There is obliteration of Sylvian aqueduct by an enlarged and convex portion of the superior tectal plate. There is no reliable evidence of parenchymal enhancement here or otherwise. There is a linear increased FLAIR signal noted around the lateral ventricles suggestive of transependymal pressure or CSF flow. The orbits, skull base and pituitary fossa are all WNL. Normal intracranial flow void seen.


Obstructive Hydrocephalus (at level of Sylvian aqueduct)

USU Teaching File MUTF - MedPix

Symmetric severe dilation of the third and lateral ventricles.  Fourth ventricle is of normal size and contour.  There is obliteration of Sylvian aqueduct by an enlarged and convex portion of the superior tectal plate.   There is no reliable evidence of parenchymal enhancement here or otherwise.  There is a linear increased FLAIR signal noted around the lateral ventricles suggestive of transependymal pressure or CSF flow.  The orbits, skull base and pituitary fossa are all WNL.  Normal intracranial flow void seen.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1410&req=5

MPX1410_synpic19205: Symmetric severe dilation of the third and lateral ventricles. Fourth ventricle is of normal size and contour. There is obliteration of Sylvian aqueduct by an enlarged and convex portion of the superior tectal plate. There is no reliable evidence of parenchymal enhancement here or otherwise. There is a linear increased FLAIR signal noted around the lateral ventricles suggestive of transependymal pressure or CSF flow. The orbits, skull base and pituitary fossa are all WNL. Normal intracranial flow void seen.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Obstructive Hydrocephalus (at level of Sylvian aqueduct)

History: Pt is a 10 y/o bright male with a h/o developmental tremor and some degree of gait asymmetry/ right toe flat walking with a short h/o new onset severe headache with associated loss of balance leading to fall, no LOC. Previous hx unknown.

Findings: Symmetric severe dilation of the third and lateral ventricles. Fourth ventricle is of normal size and contour. There is obliteration of Sylvian aqueduct by an enlarged and convex portion of the superior tectal plate. There is no reliable evidence of parenchymal enhancement here or otherwise. There is a linear increased FLAIR signal noted around the lateral ventricles suggestive of transependymal pressure or CSF flow. The orbits, skull base and pituitary fossa are all WNL. Normal intracranial flow void seen

Ddx: Obstructive hydrocephalus resulting from stenosis at the aqueduct of Sylvius. Although the stenosis may be congenital the images suggest a low grade neoplasm of the tectal plate.

Dxhow: Imaging diagnosis

Exam: GEN: WNWD. Mental Status: awake, responsive, alert and oriented X 3. Head/Neck: normocephalic, supple without masses. Eyes: See neuro exam. Ears Clear TM’s, normal canals. Nose/Sinuses: Normal. Throat/Mouth/Teeth: Normal. Chest/Lungs: Equal BS, no rales, ronchi, wheezes or rubs. Heart: No gallops, rubs or murmurs. Abdomen: Soft, nontender, normal BS, no organomegaly. Male genitalia: Normal phallus, bilaterally descended testes with normal size, position, and consistency, no inguinal hernia. Back: Nornal. Neuro: Bright, articulate, inquisitive, fluent speech, excellent math and recall Reflexes symmetric, no pathologic reflexes EOMI, PERRL, bilat papilladema, ou 20/20, face symmetry, gag symmetry, corneal reflex intact Mild hypesthesia in right face. No pronator drift, symmetric strength Bilat UE intention tremor, dysmetria, and dysdiadochokinesis Bilat LE normal gait, no dysmetria, normal tandem walk Extremeties: no clubbing, cyanosis or edema. Skin: No lesions, no petechiae, no decubiti

No MeSH data available.