A surgical case of longstanding aqueductal stenosis improved by ventriculoperitoneal shunt

Abstract

A 62-year-old female complained unsteady step and numbness in both lower extremities 4 years ago. Though computed tomography (CT) revealed enlarged ventricles, she was judged that surgical treatment was not indicated. From 1 month ago, she gradually complained gait disturbance and cognitive impairment. Magnetic resonance imaging (MRI) revealed further enlarged ventricles and aqueductal stenosis. She underwent ventriculoperitoneal shunt and improved her symptoms promptly. Though hydrocephalus due to aqueductal stenosis in middle age is rare, it’s important to differentiate from idiopathic normal pressure hydrocephalus (iNPH). Even in such a case, rapid improvement of symptoms can be expected with surgery.