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CORRESPONDENCE |
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Year : 2012 | Volume
: 60
| Issue : 4 | Page : 455-456 |
Authors' reply
Gallo Pasquale1, Szathmari Alexandru2, Simon Emile2, Ricci-Franchi Anne Claire2, Rousselle Christophe2, Hermier Marc2, C Carmine Mottolese2
1 Department of Neurological Surgery, University Hospital, Verona, Italy 2 Department of Pediatric Neurosurgery, Hopital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
Date of Web Publication | 6-Sep-2012 |
Correspondence Address: Gallo Pasquale Department of Neurological Surgery, University Hospital, Verona Italy
 Source of Support: None, Conflict of Interest: None  | Check |

How to cite this article: Pasquale G, Alexandru S, Emile S, Claire RFA, Christophe R, Marc H, Mottolese C C. Authors' reply. Neurol India 2012;60:455-6 |
Sir,
We really appreciate the interest in our article and the comments. [1],[2] Trapped fourth ventricle is mostly seen as a sequela in patients with ventricular shunt placed to treat a posthemorrhagic or postmeningitic hydrocephalus.[3],[4] The endoscopic aqueductoplasty and stent placement treats the isolation enlarged fourth ventricle and resolves the clinical symptomatology in the majority of cases.[5] This procedure also avoids the need for fourth ventricle shunt insertion and the associated complications.[6] However, it cannot restore the physiological reabsorption pattern which is lost in these patients. They need a working ventriculo-peritoneal (VP) supratentorial shunt to treat the hydrocephalus. Even though they usually have less shunt revisions compared with patients harboring a VP shunt and fourth ventricle shunt, they could have supratentorial shunt malfunction as well.
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1. | Yadav YR, Parihar V. The endoscopic trans-fourth ventricle aqueductoplasty and stent placement for the treatment of trapped fourth ventricle; stent blockage complications under estimated? Neurol India 2012;60:455.  |
2. | Gallo P, Szathmari A, Simon E, Ricci-Franchi A, Rousselle C, Hermier M, et al. The endoscopic trans-fourth ventricle aqueductoplasty and stent placement for the treatment of trapped fourth ventricle: Longterm results in a series of 18 consecutive patients. Neurol India 2012;60:271-7.  |
3. | Oi S, Matsumoto S. Pathophysiology of aqueductal obstruction in isolated IV ventricle after shunting. Childs Nerv Syst 1986;2:282-6.  [PUBMED] |
4. | Hawkins JC, Hoffman HJ, Humphrey RP. Isolated fourth ventricle as a complication of ventricular shunting. J Neurosurg 1978;49:910-3.  |
5. | Fritsch MJ, Kienke S, Manwaring KH, Mehdorn HM. Endoscopic aqueductoplasty and interventriculustomy for the treatment of isolated fourth ventricle in children. Neurosurgery 2004;55:372-7.  [PUBMED] |
6. | Mohanty A. Endoscopic options in the management of isolated fourth ventricles. J Neurosurg 2006;104 (Suppl 1):S73-8.  |
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