Individualized retrograde endoscopic transoccipital-fourth ventricular-midbrain aqueduct to third and lateral ventriculoperitoneal shunt for complex multilocular hydrocephalus with isolated fourth ventricle: a case report

Hydrocephalus is a condition frequently encountered in neurosurgery. An isolated fourth ventricle represents one of the most challenging forms of hydrocephalus. Currently, there are few clinically mature single-session surgical solutions available for the treatment of complex hydrocephalus with an i...

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Bibliographic Details
Main Authors: Bodong Wang, Xiaogang Wang, Qiang Liu, Ruwen Ma, Weijie Zhu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1411371/full
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Summary:Hydrocephalus is a condition frequently encountered in neurosurgery. An isolated fourth ventricle represents one of the most challenging forms of hydrocephalus. Currently, there are few clinically mature single-session surgical solutions available for the treatment of complex hydrocephalus with an isolated fourth ventricle that exhibits both obstructive and communicating features. Herein, we report a case of complex hydrocephalus with an isolated fourth ventricle treated with an endoscopic transmesencephalic aqueduct retrograde shunt. The patient recovered well postoperatively, with significant improvement in hydrocephalus symptoms. Based on a thorough analysis of the etiology, we suggest that shunt surgery using an endoscopic transoccipital-fourth ventricle-midbrain aqueduct-third ventricle-lateral ventricle retrograde approach can be applied to patients with complex hydrocephalus, using an individualized plan. The successful treatment in our case provides a reference for the management of patients with complex hydrocephalus and an isolated fourth ventricle.
ISSN:2296-858X