Sagittal T1-weighted (image 1) and coronal T2-weighted (imag | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

You can view up to 4 cases without signing up.

Sagittal T1-weighted (image 1) and coronal T2-weighted (image 2) MRI in an infant with aqueductal stenosis shows massive ventriculomegaly (arrow), an encephalocele (small arrow) arising from the posterior parietal convexity, and a large retrocerebellar cerebral spinal fluid space (dashed arrow) consistent with a Dandy-Walker malformation. Aqueductal stenosis refers to narrowing of the aqueduct of Sylvius. On imaging, the lateral and third ventricles are markedly dilated; the mildly fourth ventricle has a normal appearance. Associated ventricular rupture is uncommon. #NeuroWednesday

Why you should join Figure 1

• Share your knowledge with our global community of healthcare professionals
• Get help from experts in your field
• Learn from our library of real-world cases and quizzes

Similar cases

Fetal MRI (image 1) shows massive enlargement of the lateral ventricles and stenosis (arrow on MRI) of the aqueduct of Sylvius. Aqueductal stenosis is one of the most common causes of fetal hydrocephalus. The narrowing of the aqueduct of Sylvius causes enlargement of the lateral and third ventricles. However, the fourth ventricle is normal in size as it is distal to the stenosis. Patients are treated with a ventriculoperitoneal shunt and may also undergo 3rd ventriculostomy.

Axial (image 1) and sagittal (image 2) T2-weighted MRI shows massive hydrocephalus with enlargement of the lateral ventricles. The fourth ventricle (arrow) is normal in size on the sagittal image. The cerebellar tonsils are herniated through the foramen magnum.

Axial (image 1) and sagittal (image 2) images from a fetal MRI show marked hydrocephalus. While there is a large volume of fluid in the posterior fossa, the fourth ventricle is not seen and the cerebral aqueduct is not visible.

Sagittal T2W MRI shows a massively enlarged head with a large volume of CSF. The axial images helped to confirm that the lateral ventricles were massively enlarged and had ruptured. The 3rd ventricle (dashed arrow) is enlarged and does not connect with the normal 4th ventricle (arrow). The findings are consistent with severe aqueductal stenosis. #NeuroWednesday.