[A case of aqueductal stenosis with acute progressive hydrocephalus during pregnancy].
The authors present a case of aqueductal stenosis (AS) with acute progressive symptoms during pregnancy. A 39-year-old pregnant woman in 19th gestation week was admitted with headache, nausea and deterioration of consciousness. On admission, computed tomography (CT) scan showed acute hydrocephalus. Ventricular drainage was performed on emergency and her symptoms were resolved in a few days. Postoperative T2-weighted MR images showed enlargement of the lateral and third ventricles with membranous occlusion of the aqueduct. Endoscopic third ventriculostomy was performed uneventfully. A healthy baby was delivered by Cesarean section in 36th gestation week considering her previous extirpation of hysteromyoma. In this case of pregnant woman, increase of total body water, cardiac output, and central venous pressure, and decrease in plasma osmotic pressure might contribute to development and sudden worsing of symptoms of pre-existed hydrocephalus due to aqueductal stenosis. Endoscopic third ventriculostomy, especially in the pregnant case, should be recommended in hydrocephalus due to aqueductal stenosis to avoid shunt malfunction caused by increasing intraabdominal pressure and shunt infecton during Cesarean section.
Watanabe
Yosuke
Y
Department of Neurosurgery, Hiroshima City Asa Hospital, Hiroshima, Japan.
Oki
Shuichi
S
Sumida
Masayuki
M
Isobe
Naoyuki
N
Kanou
Yukari
Y
Takeda
Masaaki
M
D000328:Adult; D002535:Cerebral Aqueduct / Q000000981:diagnostic imaging / Q000473:pathology*; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011248:Pregnancy Complications; D014057:Tomography, X-Ray Computed; D014696:Ventriculostomy