Cinalli Giuseppe, Spennato Pietro, Nastro Anna, Aliberti Ferdinando, Trischitta Vincenzo, Ruggiero Claudio, Mirone Giuseppe, Cianciulli Emilio
Department of Pediatric Neurosurgery, Santobono Children's Hospital, Via Mario Fiore n. 6, 80129 Naples, Italy.
Childs Nerv Syst. 2011 Oct;27(10):1621-42. doi: 10.1007/s00381-011-1546-2. Epub 2011 Sep 17.
The sylvian aqueduct is the most common site of intraventricular blockage of the cerebro-spinal fluid. Clinical aspects, neuroradiological appearance, and treatment of hydrocephalus secondary to aqueductal stenosis are specific.
An extensive literature review concerning etiologic, pathogenetic, clinical, and neuroradiological aspects has been performed. Therapeutic options, prognosis, and intellectual outcome are also reviewed.
The correct interpretation of the modern neuroradiologic 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.
中脑导水管是脑脊液脑室系统梗阻最常见的部位。导水管狭窄继发脑积水的临床症状、神经放射学表现及治疗具有特异性。
对病因、发病机制、临床及神经放射学方面进行了广泛的文献综述。还对治疗选择、预后及智力转归进行了综述。
正确解读现代神经放射学技术有助于在两种主要治疗选择（第三脑室造瘘术或分流术）之间选择合适的治疗方法。在过去几十年中，内镜下第三脑室造瘘术已成为导水管狭窄的一线治疗方法；然而，一些问题，如精心挑选的患者治疗失败的原因、接受内镜下第三脑室造瘘术治疗的婴儿的长期预后以及持续性脑室扩大对神经心理发育的影响，仍未得到解答。
