title: Bilateral occlusion of the foramina of Monro after endoscopic third ventriculostomy for aqueductal stenosis--a case report.
abstract: METHODS
  Bilateral occlusion of the foramina of Monro is an extremely rare clinical condition. We present the case of a 10-year-old girl who complained of frequent headaches.
  
  
  METHODS
  Magnetic resonance imaging showed triventricular hydrocephalus due to aqueductal stenosis, so endoscopic third ventriculostomy was performed successfully. The headaches subsequently disappeared, but the patient presented with exacerbation of headaches 32 months postoperatively. Magnetic resonance imaging demonstrated bilateral hydrocephalus of the lateral ventricles, implying bilateral occlusion of the foramina of Monro. We again performed endoscopic surgery, confirming bilateral occlusion of the foramina of Monro.
  
  
  RESULTS
  The foramina of Monro were apparently obstructed by normal ependyma, and no tumor masses or other structures were detected around the foramina, so we diagnosed the occlusion of the foramina as secondary after endoscopic third ventriculostomy. We fenestrated the septum pellucidum using a monopolar micro endoscopic electrode, and a ventriculoperitoneal shunt was placed for the management of hydrocephalus. The postoperative course was uneventful, and the headaches were completely resolved.
authors.affiliation: Department of Neurosurgery, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan. you1ngta@gmail.com.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Nagata
authors.affiliation: Department of Neurosurgery, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Takeuchi
authors.affiliation: Department of Neurosurgery, Japanese Red Cross Nagoya Daini Hospital, 2-9 Myoken-cho, Showa-ku, Nagoya, Aichi, 466-8650, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Nagatani
authors.affiliation: Department of Neurosurgery, Japanese Red Cross Nagoya Daini Hospital, 2-9 Myoken-cho, Showa-ku, Nagoya, Aichi, 466-8650, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Neurosurgery, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Neurosurgery, Japanese Red Cross Nagoya Daini Hospital, 2-9 Myoken-cho, Showa-ku, Nagoya, Aichi, 466-8650, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Tambara
authors.affiliation: Department of Neurosurgery, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Wakabayashi
mesh_terms: D002552:Cerebral Ventricles / Q000000981:diagnostic imaging / Q000601:surgery*; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D044583:Neuroendoscopy / Q000379:methods*; D014696:Ventriculostomy / Q000379:methods*
keywords: Aqueductal stenosis; Endoscopic third ventriculostomy; Foramen of Monro; Headache; Hydrocephalus; Occlusion