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Croatian medical journal, Vol.55 No.4 August 2014. -

The aim of this study is to present the five-year longitudinal

magnetic resonance imaging MRI follow up of a patient

with incidental finding of near-obstruction stenosis

of the aqueduct of Sylvius due to a large pineal cyst. The

patient was scanned 3 times on a 3T MR device using a

set of standard structural sequences supplemented with

high-resolution constructive interference of steady state

CISS T2 sequence for precise delineation of the aqueduct

of Sylvius and cardiac-gated phase-contrast sequences for

the analysis of cerebrospinal fluid CSF movement. On all

MR scans, the size of the pineal cyst and severity of nearobstruction

aqueductal stenosis did not show any morphological

changes. There was no significant ventricular

enlargement although structural CISS sequence showed

a near-obstruction stenosis and cardiac-gated phase-contrast

sequences did not detect CSF movement through

the aqueduct of Sylvius. Our findings are contradictory to

the classic hypothesis of CSF physiology based on secretion,

circulation, and absorption of CSF, which states that

the impairment of CSF circulation through the aqueduct

of Sylvius inevitably leads to a hypertensive hydrocephalus

development involving the third and the lateral ventricle.

Our research group previously proposed a new hypothesis

of CSF physiology, which offers more suitable explanation

for such clinical cases.



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Fuente: http://hrcak.srce.hr/



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