title: Paradoxical ventriculomegaly due to low-pressure hydrocephalus, a rare complication of the treatment of a trapped fourth ventricle: Case report.
abstract: In this paper, we describe the rare phenomena of descending transtentorial herniation and paradoxical ventriculomegaly due to low pressure hydrocephalus. This resulted as a complication of treatment in a 14year old male patient, who had undergone multiple ventriculo-peritoneal shunt placements for hydrocephalus after resection of pilocytic astrocytoma. We discuss the etiology of this rare complication and our strategy for treatment. We emphasize the need for strategic placement of programmable shunts to avoid over shunting and associated complications such as tentorial herniation.
authors.affiliation: Department of Neurosurgery, Rabin Medical Center, Petah Tiqva, Israel.
authors.forename: Neelan J
authors.initials: NJ
authors.lastname: Marianayagam
authors.affiliation: Department of Neurosurgery, Rabin Medical Center, Petah Tiqva, Israel.
authors.forename: Netanel Ben
authors.initials: NB
authors.lastname: Shalom
authors.affiliation: Department of Neurosurgery, Rabin Medical Center, Petah Tiqva, Israel.
authors.forename: Saeed
authors.initials: S
authors.lastname: Yassin
authors.affiliation: Department of Neurosurgery, Rabin Medical Center, Petah Tiqva, Israel; Pediatric Neurosurgery Unit, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel.
authors.forename: Shalom
authors.initials: S
authors.lastname: Michowiz
authors.affiliation: Department of Neurosurgery, Rabin Medical Center, Petah Tiqva, Israel.
authors.forename: Sagi
authors.initials: S
authors.lastname: Harnof
authors.affiliation: Department of Neurosurgery, Rabin Medical Center, Petah Tiqva, Israel; Pediatric Neurosurgery Unit, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel. Electronic address: rajzgustavo@hotmail.com.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Rajz
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000601:surgery*; D004677:Encephalocele / Q000209:etiology*; D020546:Fourth Ventricle / Q000000981:diagnostic imaging*; D006801:Humans; D006849:Hydrocephalus / Q000150:complications*; D008297:Male; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D017287:Ventriculoperitoneal Shunt / Q000379:methods*
keywords: Low pressure hydrocephalus; Transtentorial herniation; Trapped fourth ventricle; Ventriculo-peritoneal shunt