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Non-communicating Hydrocephalus - Aqueductal Stenosis - Case 2

A 35 year-old man presented with headaches and gait imbalance. There was a history of meningitis as a child.

Show the Normal Size 4th Ventricle                 Show the Enlarged Third and Lateral Ventricles

Flair axial MRI images - note the prominent enlargement of the lateral and third ventricles but with a normal size appearance of the 4th ventricle (left image).  This pattern is one of obstructive hydrocephalus, which occurs from impaired drainage through the cerebral aqueduct (connecting the third to the fourth ventricles).  Note also the relatively effaced (i.e. small) sulci, which excludes the possibility of large due to atrophy (i.e., hydrocephalus ex vacuo).

Revised 04/21/06.
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