Active hydrocephalus with aqueduct stenosis to an old woman

Abstract

Introduction: Aqueduct stenosis (AS) in old people is a rare pathological entity. I report a case of a 66 years old woman with severe ataxia, cognitive deterioration, loss of sphincters control (gatism). Clinical, neuro-radiologic and therapeutic considerations are discussed. Case presentation: A 66 years old woman with a 6 months history of mild cerebral trauma by car accident without losing consciousness, present 2 months before hospitalization severe ataxia, cognitive disorders, gatism. At the time of trauma, brain scanner performed in another institution showed minimal fronto-basal cerebral contusions and blood collection around the brain stem. One month after a new unenhanced brain scan all previous lesions are gone. At admission, an abnormal enlargement of lateral and third ventricles are remarked both on unenhanced CT and MRI scan of the brain explained by cerebral aqueductal stenosis. Ventricular open pressure was 350 mm H2O. A ventriculoperitoneal shunt with a variable pressure valve was installed. The surgery went uneventful and the patient recovered as expected. 6-month follow-up visit the patient was symptom-free, with a fine intellectual recovery.