title: Disproportionately large communicating fourth ventricle associated with syringomyelia and intradural arachnoid cyst in the spinal cord successfully treated with additional shunting. Case report.
abstract: A 44-year-old woman presented with a rare case of disproportionately large communicating fourth ventricle (DLCFV) associated with syringomyelia and intradural arachnoid cyst in the spinal cord. Ventriculoperitoneal shunt operation was performed for hydrocephalus after subarachnoid hemorrhage. She developed DLCFV, which was then associated with syringomyelia and spinal intradural arachnoid cyst. Shunting of the fourth ventricle improved DLCFV, and then the syringomyelia and arachnoid cyst. Although the aqueduct was patent, independent pressure control of the fourth ventricle and the other ventricles was necessary to improve the symptoms. Shunting of the fourth ventricle should be considered for patients with DLCFV when the symptoms persist despite adequate pressure control of the other ventricles.
authors.affiliation: Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
authors.forename: Tae
authors.initials: T
authors.lastname: Yamashita
authors.forename: Hisaya
authors.initials: H
authors.lastname: Hiramatsu
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kitahama
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Tokuyama
authors.forename: Kenji
authors.initials: K
authors.lastname: Sugiyama
authors.forename: Hiroki
authors.initials: H
authors.lastname: Namba
mesh_terms: D000328:Adult; D016080:Arachnoid Cysts / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D020546:Fourth Ventricle / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D006849:Hydrocephalus / Q000150:complications* / Q000503:physiopathology / Q000601:surgery*; D020547:Lateral Ventricles / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D013118:Spinal Cord Diseases / Q000209:etiology* / Q000503:physiopathology; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000503:physiopathology; D013595:Syringomyelia / Q000209:etiology* / Q000503:physiopathology; D017287:Ventriculoperitoneal Shunt / Q000295:instrumentation / Q000379:methods*