Abstract
The Sylvian aqueduct is a narrow channel, about 15 mm long, that connects the third and the fourth ventricle. Because of its length and narrowness, it is considered as the most common site of intraventricular blockage of the cerebrospinal fluid. Aqueductal stenosis is responsible of 6–66% of cases of hydrocephalus in children (more than 50% presenting in the first year of life) and 5–49% in adults. In this chapter, pathological and etiological findings, specific clinical aspects, neuroradiological appearance, and therapeutic options of hydrocephalus secondary to aqueductal stenosis are exhaustively reviewed. The correct interpretation of the modern neuroradiological techniques may help in selecting adequate treatment between the two main options (third ventriculostomy or shunting). In the last decades, endoscopic third ventriculostomy has become the first-line treatment of aqueductal stenosis; however, some issues, such as the cause of failures in well-selected patients, long-term outcome in infant treated with ETV, and effect of persistent ventriculomegaly on neuropsychological developmental, remain unanswered.
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Spennato, P., Cinalli, G., Cianciulli, E., d’Armiento, M. (2019). Aqueductal Stenosis and Hydrocephalus. In: Cinalli, G., Ozek, M., Sainte-Rose, C. (eds) Pediatric Hydrocephalus. Springer, Cham. https://doi.org/10.1007/978-3-319-31889-9_19-1
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