Kuroki T, Matsumoto M, Ohishi H, Yamashita K, Sugo N, Terao H, Kushida Y
Department of Neurosurgery, Sakura Hospital of Toho University Medical School.
No Shinkei Geka. 1992 Jun;20(6):707-11.
Although both "Isolated Fourth Ventricle" (IFV) and "Disproportionately Large, Communicating Fourth Ventricle" (DLCFV) are the clinical-radiologic entities characterized by a dilatation of the fourth ventricle, DLCFV must be separated from IFV because of its apparent patency of the aqueduct. In some Japanese literature, however, there was some confusion concerning DLCFV and so-called "reversible DLCFV" or IFV with "one way aqueduct". In this paper, comparing DLCFV with IFV, a reasonable pathogenesis of DLCFV was discussed on the basis of clinico-radiological analysis of four cases of DLCFV. Our tentative conclusion is as follows: 1) Whether there is radiologic aqueductal patency or not, the term of DLCFV should not be primarily reserved for patients who have had shunting of the lateral ventricle for previous hydrocephalus." 2) It was strongly suggested that a mechanism involved in the development of DLCFV was the formation "membranous occlusion" in/or near the foramen Magendie.
尽管“孤立性第四脑室”（IFV）和“不成比例增大的交通性第四脑室”（DLCFV）都是以第四脑室扩张为特征的临床-放射学实体，但由于导水管明显通畅，DLCFV必须与IFV区分开来。然而，在一些日本文献中，关于DLCFV以及所谓的“可逆性DLCFV”或具有“单向导水管”的IFV存在一些混淆。在本文中，通过将DLCFV与IFV进行比较，基于对4例DLCFV病例的临床-放射学分析，探讨了DLCFV合理的发病机制。我们的初步结论如下：1）无论放射学上导水管是否通畅，DLCFV这一术语不应主要保留给既往因脑积水而行侧脑室分流术的患者。2）强烈提示，DLCFV发生发展所涉及的机制是在马根迪孔内或其附近形成“膜性阻塞”。
