title: Neuroendoscopic treatment of idiopathic occlusion of the foramen of Monro in adults--two case reports.
abstract: Two adults presented with hydrocephalus due to idiopathic obstruction of the bilateral foramina of Monro, manifesting as clinical signs of chronically elevated intracranial pressure. No inflammation was present. The primary surgical treatment was neuroendoscopic reconstruction of the right foramen of Monro. A 37-year-old man had a spontaneous perforation of the septum pellucidum. The patient required a ventriculoperitoneal shunt, although postoperative ventriculography proved free passage of cerebrospinal fluid from the lateral ventricle into the third ventricle. A 62-year-old man underwent additional septostomy and third ventriculostomy, and the neuroendoscopic intervention relieved the presenting symptoms without additional treatment. The biopsy specimens showed no evidence of malignancy in either case. Neuroendoscopic intervention is an alternative treatment in the management of hydrocephalus due to idiopathic obstruction of the foramen of Monor. The procedure is less invasive than open microsurgical reconstruction and can even avoid ventriculoperitoneal or ventriculoatrial shunting.
authors.affiliation: Department of Neurosurgery, University Hospital-Eberhard-Karls University Tübingen, Tübingen, Germany. dkfreude@med.uni-tuebingen.de
authors.forename: Dirk
authors.initials: D
authors.lastname: Freudenstein
authors.forename: Frank
authors.initials: F
authors.lastname: Duffner
authors.forename: Hilmar
authors.initials: H
authors.lastname: Krapf
authors.forename: Alexandra
authors.initials: A
authors.lastname: Wagner
authors.forename: Ernst H
authors.initials: EH
authors.lastname: Grote
mesh_terms: D000328:Adult; D002552:Cerebral Ventricles / Q000601:surgery*; D004724:Endoscopy; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous; D012688:Septum Pellucidum / Q000601:surgery; D017287:Ventriculoperitoneal Shunt