Download PDF
CC BY-NC-ND 4.0 · J Neurol Surg Rep 2025; 86(01): e4-e7
DOI: 10.1055/s-0044-1788037
Case Report

Late Presentation of Congenital Aqueduct Stenosis in Adulthood with High-Riding Basilar Artery: Case Report

Hassan Mohammed Alturiki 
1   Faculty of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
,
Batool M. Alqudihi
2   Faculty of Medicine, Hacettepe University, Ankara, Turkey
,
Shima Alboesa
1   Faculty of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
,
Abdullah H. Alramadan
3   Department of Neurosurgery and Spine Surgery, Qatif Central Hospital, Qatif, Saudi Arabia
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Background A rare variant of congenital aqueductal stenosis (CAS) is known as adult-onset CAS, characterized by the emergence of symptoms during adulthood.

Case Description A 35-year-old man presented complaining of acute-onset headache and vomiting. Magnetic resonance imaging of the brain revealed an acute hydrocephalus due to an aqueductal web. The patient was treated with a ventriculoperitoneal shunt and doing well. His condition was complicated by subdural hematoma as a result of overshunting, which was treated by frontoparietal craniotomy and eventually, he underwent valve revision to a programmable valve.

Conclusion Additional research is needed to gain a deeper understanding of the hypothesis related to adult aqueductal stenosis. This will help shed light on the asymptomatic childhood phase and potentially reduce complications by identifying late CAS early.

Keywords

aqueductal - stenosis - congenital - high-riding basilar - subdural - hematoma


Publication History

Received: 06 March 2024

Accepted: 05 June 2024

Article published online:
20 January 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Spennato P, Cinalli G, Cianciulli E, D'Armiento M. Aqueductal stenosis and hydrocephalus. In: Pediatric Hydrocephalus. 2nd ed. Vol. 2. 2018: 933-962
    Search in Google Scholar
  • 2 Rodis I, Mahr CV, Fehrenbach MK. et al. Hydrocephalus in aqueductal stenosis–a retrospective outcome analysis and proposal of subtype classification. Childs Nerv Syst 2016; 32 (04) 617-627
    CrossrefPubMedSearch in Google Scholar
  • 3 Naureen I, Saleem A, Ghafoor M. et al. Genetics of hydrocephalus (HC). East African Scholars Multidisciplinary Bulletin 2022; 5 (09) 176-184
    CrossrefPubMedSearch in Google Scholar
  • 4 Verhagen WI, Bartels RH, Fransen E, van Camp G, Renier WO, Grotenhuis JA. Familial congenital hydrocephalus and aqueduct stenosis with probably autosomal dominant inheritance and variable expression. J Neurol Sci 1998; 158 (01) 101-105
    CrossrefPubMedSearch in Google Scholar
  • 5 Harrison MJG, Robert CM, Uttley D. Benign aqueduct stenosis in adults. J Neurol Neurosurg Psychiatry 1974; 37 (12) 1322-1328
    CrossrefPubMedSearch in Google Scholar
  • 6 Brar KS, Sharma AK, Nathan A, Nathan A. A rare case of congenital aqueductal stenosis. Med J Armed Forces India 2013; 69 (02) 181-183
    CrossrefPubMedSearch in Google Scholar
  • 7 Little JR, Houser OW, MacCarty CS. Clinical manifestations of aqueductal stenosis in adults. J Neurosurg 1975; 43 (05) 546-552
    CrossrefPubMedSearch in Google Scholar
  • 8 Tisell M. How should primary aqueductal stenosis in adults be treated? A review. Acta Neurol Scand 2005; 111 (03) 145-153
    CrossrefPubMedSearch in Google Scholar
  • 9 Tisell M, Tullberg M, Hellström P, Blomsterwall E, Wikkelsø C. Neurological symptoms and signs in adult aqueductal stenosis. Acta Neurol Scand 2003; 107 (05) 311-317
    CrossrefPubMedSearch in Google Scholar
  • 10 Muzumdar D, Nadkarni T, Goel A. Spontaneous cerebrospinal fluid rhinorrhea as a presenting symptom of aqueductal stenosis–case report. Neurol Med Chir (Tokyo) 2003; 43 (12) 626-629
    CrossrefPubMedSearch in Google Scholar
  • 11 Fukuhara T, Luciano MG. Clinical features of late-onset idiopathic aqueductal stenosis. Surg Neurol 2001; 55 (03) 132-136 , discussion 136–137
    CrossrefPubMedSearch in Google Scholar
  • 12 Iacob G. Active hydrocephalus due to aqueductal stenosis in an elderly woman. Rom Neurosurg 2021; ;(September): 251-256
    PubMedSearch in Google Scholar
  • 13 Bradley WG, Abdihalim M, Almutairi A. Adult onset aqueductal stenosis may become symptomatic due to deep white matter ischemia. Fluids Barriers CNS 2015; 12 (01) O26
    CrossrefPubMedSearch in Google Scholar
  • 14 Algin O, Hakyemez B, Parlak M. Phase-contrast MRI and 3D-CISS versus contrast-enhanced MR cisternography on the evaluation of the aqueductal stenosis. Neuroradiology 2010; 52 (02) 99-108
    CrossrefPubMedSearch in Google Scholar
  • 15 Algin O, Turkbey B. Evaluation of aqueductal stenosis by 3D sampling perfection with application-optimized contrasts using different flip angle evolutions sequence: preliminary results with 3T MR imaging. AJNR Am J Neuroradiol 2012; 33 (04) 740-746
    CrossrefPubMedSearch in Google Scholar
  • 16 Saxena AK, Sodhi KS, Khandelwal N. Heavily T2W 3D-SPACE images for evaluation of cerebrospinal fluid containing spaces dear. Indian J Radiol Imaging 2012; 22 (01) 74
    Thieme ConnectPubMedSearch in Google Scholar
  • 17 Mohammed H, Elsatar AEA, Ragab M, Alghriany A. Evaluation of late onset congenital aqueductal stenosis hydrocephalus. J Neurol Stroke 2016; 5 (01) 2-7
    CrossrefPubMedSearch in Google Scholar
  • 18 Lynch DG, Mehta SH, Shah KA, Toscano D, Pruitt R, Woo HH. Endoscopic third ventriculostomy using Penumbra Artemis™ neuro evacuation device: technical case report and operative video. Cureus 2023; 15 (09) e45761
    PubMedSearch in Google Scholar
  • 19 Kumar S, Sahana D, Rathore L. et al. Extra-axial endoscopic third ventriculostomy: preliminary experience with a technique to circumvent conventional endoscopic third ventriculostomy complications. J Neurosurg 2022; 138 (02) 503-513
    CrossrefPubMedSearch in Google Scholar
  • 20 Xie JS, Donaldson L, Margolin E. Papilledema: a review of etiology, pathophysiology, diagnosis, and management. Surv Ophthalmol 2022; 67 (04) 1135-1159
    CrossrefPubMedSearch in Google Scholar
  • 21 Sternbach GL. Subdural hematoma in a shunted patient. J Emerg Med 2005; 29 (04) 483-484
    CrossrefPubMedSearch in Google Scholar