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aqueductal stenosis

A narrowing or obstruction of the cerebral aqueduct (aqueduct of Sylvius). It may be congenital or caused by a blockage by infection, hemorrhage, tumor, or arachnoid cyst. It blocks the flow of cerebrospinal fluid (CSF) in the ventricular system, leading to hydrocephalus, a buildup of excess cerebrospinal fluid in the brain. The extra fluid can increase pressure in the brain, causing brain damage and mental and physical problems. (Symptoms) • "sunsetting" (downward deviation of the eyes) • very large head in relation to the rest of the body • sleepiness • vomiting • irritability • seizures (Diagnosis) Prenatal: It can be detected in a fetus as early as the 3rd or 4th month of pregnancy. • amniocentesis: A needle aspiration of intrauterine fluid. • ultrasound: Looking for an abnormal collection of fluid. Postnatal: • imaging techniques: Ultrasound, CT scans, MRI • intracranial pressure monitoring: Measures CSF pressure. (Treatment) • cerebral shunt surgery: A small opening is made in the skull to allow the upper catheter to be passed through the brain and into the ventricle, diverting excess CFS from the brain through the lower catheter under the skin through the fatty tissue to the abdomen or right atrium of the heart. - ventriculoperitoneal shunt: The lower catheter is passed to the abdomen. - ventriculoatrial shunt: The lower catheter is passed to the right atrium of the heart. • endoscopic third ventriculostomy: A small hole is made in the floor of the third ventricle of the brain, allowing the CFS to bypass the obstruction and drain. • external ventricular drain (ventriculostomy): Diverts fluid from the ventricles of the brain, tunneled out through the scalp and connected to a bedside collection system, monitoring of intracranial pressure.