Adult idiopatic occlusion of Monro foramina: Intraoperative endoscopic reinterpretation of radiological data and review of the literature

作者：Schonauer Claudio; Johnson Reuben; Chiriatti Stefano; de Falco Raffaele; Albanese Vincenzo; Tessitore Enrico; Barbagallo Giuseppe M V^*

来源：British Journal of Neurosurgery, 2014, 28(6): 717-721.

DOI：10.3109/02688697.2014.918580

• Foramen of Monro
• foraminoplasty
• MRI
• neuroendoscopy
• septum pellucidum
• thulium laser

Adult idiopathic occlusion of the foramen of Monro (AIOFM) is a rare condition, with only few cases described in the modern literature. We propose that AIOFM may result from unilateral or bilateral occlusion of Monro foramina, as well as from progression of a monolateral hydrocephalus. Different surgical strategies may be required for effective treatment according to the type of occlusion. To date, only 12 cases of AIOFM have been reported in the literature. We report the cases of two patients, aged 20 and 47 years respectively, who presented with intracranial hypertension secondary to bilateral ventricular dilatation due to obstruction at the level of the foramen of Monro. Both patients were successfully treated with endoscopic fenestration of the primarily obstructed foramen of Monro and, in one patient, fenestration of the septum. We propose that septum pellucidum displacement could play a role in the occlusion of the second foramen of Monro. AIOFM can, therefore, result also from unilateral stenosis of Monro. The difference in AIOFM (i.e. unilateral vs bilateral) will be useful in guiding the most suitable surgical approach in this rare condition.

• 出版日期2014-12