caa a22 4500 445807083 CHVBK 20180317145159.0 cr unu---uuuuu 170323e20110101xx s 000 0 eng 10.1007/s00415-010-5678-1 doi (NATIONALLICENCE)springer-10.1007/s00415-010-5678-1 Size of third and fourth ventricle in obstructive and communicating acute hydrocephalus after aneurysmal subarachnoid hemorrhage [Elektronische Daten] [D. Knol, J. van Gijn, C. Kruitwagen, G. Rinkel] In patients with acute hydrocephalus after aneurysmal subarachnoid haemorrhage (SAH), lumbar drainage is possible if the obstruction is in the subarachnoid space (communicating hydrocephalus). In case of intraventricular obstruction (obstructive hydrocephalus), ventricular drainage is the only option. A small fourth ventricle is often considered a sign of obstructive hydrocephalus. We investigated whether the absolute or relative size of the fourth ventricle can indeed distinguish between these two types of hydrocephalus. On CT-scans of 76 consecutive patients with acute headache but normal CT and CSF, we measured the cross-sectional surface of the third and fourth ventricle to obtain normal planimetric values. Subsequently we performed the same measurements on 117 consecutive SAH patients with acute hydrocephalus. These patients were divided according to the distribution of blood on CT-scan into three groups: mainly intraventricular blood (n=15), mainly subarachnoid blood (n=54) and both intraventricular and subarachnoid blood (n=48). The size of the fourth ventricle exceeded the upper limit of normal in 2 of the 6 (33%) patients with intraventricular blood but without haematocephalus, and in 15 of the 54 (28%) patients with mainly subarachnoid blood. The mean ratio between the third and fourth ventricle was 1.45 (SD 0.66) in patients with intraventricular blood and 1.42 (SD 0.91) in those with mainly subarachnoid blood. Neither fourth ventricular size nor the ratio between the third and fourth ventricles discriminates between the two groups. A small fourth ventricle does not necessarily accompany obstructive hydrocephalus and is therefore not a contraindication for lumbar drainage. The Author(s), 2010 Subarachnoid haemorrhage nationallicence Cerebral aneurysm nationallicence Acute hydrocephalus nationallicence Knol D. Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, PO box 85500, 3508 GA, Utrecht, The Netherlands aut van Gijn J. Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, PO box 85500, 3508 GA, Utrecht, The Netherlands aut Kruitwagen C. Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands aut Rinkel G. Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, PO box 85500, 3508 GA, Utrecht, The Netherlands aut Journal of Neurology Springer-Verlag 258/1(2011-01-01), 44-49 0340-5354 258:1<44 2011 258 415 https://doi.org/10.1007/s00415-010-5678-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00415-010-5678-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Knol D. Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, PO box 85500, 3508 GA, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- van Gijn J. Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, PO box 85500, 3508 GA, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Kruitwagen C. Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Rinkel G. Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, PO box 85500, 3508 GA, Utrecht, The Netherlands aut NATIONALLICENCE 773 0- Journal of Neurology Springer-Verlag 258/1(2011-01-01), 44-49 0340-5354 258:1<44 2011 258 415 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer