Suprapineal recess: an alternate site for third ventriculostomy? Case report.
This 30-year-old woman presented with clinical symptoms and signs of intracranial hypertension and Parinaud syndrome secondary to ventriculoperitoneal shunt dysfunction. Magnetic resonance (MR) imaging revealed gross triventricular hydrocephalus with a large suprapineal recess due to aqueductal stenosis. Using an endoscopic approach, a ventriculostomy was performed within the floor of the dilated suprapineal recess. Following this procedure the patient experienced alleviation of all her neurological symptoms and signs. Postoperative MR imaging and cerebrospinal fluid flow studies demonstrated a functioning ventriculostomy. The anatomy of the suprapineal recess and its suitability for endoscopic ventriculostomy are discussed.
Daniel
Roy Thomas
RT
Department of Neurosurgery, Royal Adelaide South Hospital, Adelaide, Australia. roymercy@hotmail.com
Lee
Gabriel Yin Foo
GY
Reilly
Peter Lawrence
PL
D000328:Adult; D002535:Cerebral Aqueduct / Q000473:pathology / Q000601:surgery*; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000601:surgery; D004724:Endoscopy; D004868:Equipment Failure; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000601:surgery*; D007091:Image Processing, Computer-Assisted; D019586:Intracranial Hypertension / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008326:Mammillary Bodies / Q000473:pathology / Q000601:surgery; D008866:Microsurgery; D010870:Pineal Gland / Q000473:pathology / Q000601:surgery*; D010904:Pituitary Gland, Posterior / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery*; D012086:Reoperation; D020542:Third Ventricle / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D017287:Ventriculoperitoneal Shunt; D014696:Ventriculostomy / Q000379:methods*