title: Expanding lacunae causing triventricular hydrocephalus. Report of two cases.
abstract: Two patients are reported in whom the presence of triventricular hydrocephalus and aqueductal obstruction or stenosis due to multiple expanding lacunae in the mesencephalothalamic region possibly corresponds to abnormally dilated perivascular spaces. Placement of a ventriculoperitoneal cerebrospinal fluid (CSF) shunt in one patient and the performance of a third ventricle cisternotomy in the other reversed the hydrocephalic syndrome, but did not modify the complex neuroophthalmological disturbance and rubral tremor presumably related to the compressive effects of the lacunae on adjacent parenchyma. In one patient the number and size of the lacunae were increased 4 years after CSF shunt placement. A review of the literature revealed two cases in which magnetic resonance imaging demonstrated a similar, poorly understood pathological condition.
authors.affiliation: Dipartimento de Fisiopatologia Clinica, Clinica Neurologica, Università di Firenze, Florence, Italy. m.mascalchi@dfc.unifi.it
authors.forename: M
authors.initials: M
authors.lastname: Mascalchi
authors.forename: F
authors.initials: F
authors.lastname: Salvi
authors.forename: U
authors.initials: U
authors.lastname: Godano
authors.forename: M
authors.initials: M
authors.lastname: Nistri
authors.forename: R
authors.initials: R
authors.lastname: Taiuti
authors.forename: M
authors.initials: M
authors.lastname: Tosetti
authors.forename: N
authors.initials: N
authors.lastname: Villari
authors.forename: F
authors.initials: F
authors.lastname: Calbucci
mesh_terms: D001927:Brain Diseases / Q000150:complications*; D002552:Cerebral Ventricles / Q000601:surgery; D004724:Endoscopy; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000139:chemically induced / Q000209:etiology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008636:Mesencephalon; D008875:Middle Aged; D009420:Nervous System / Q000503:physiopathology; D009460:Neurologic Examination; D011184:Postoperative Period; D013788:Thalamus; D017287:Ventriculoperitoneal Shunt