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Infant with absence seizure- like episodes
Teaching NeuroImages Neurology Resident and Fellow Section ©2017 American Academy of Neurology
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Vignette 4-month-old male baby
Brought with of history of two absence seizure- like episodes since birth. On examination, he was afebrile. ©2017 American Academy of Neurology V. Sivakumar et al
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Imaging V. Sivakumar et al
Figure 1: Axial T2 weighted images (A, B) and coronal T1 weighted image (C) shows univentricular hydrocephalus involving the left lateral ventricle (white arrows) ©2017 American Academy of Neurology V. Sivakumar et al
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Imaging V. Sivakumar et al
Figure 2: (A) Coronal T1 weighted image shows univentricular hydrocephalus involving the left lateral ventricle with membrane obstructing left foramen of Monroe (straight white arrow). Curved white arrow shows patent right foramen of Monroe. Curved arrow in (B) shows patent right foramen of Monroe on sagittal T1 weighted image. Straight white arrow in (C) shows membrane obstructing left foramen of Monroe on sagittal T1 weighted image. ©2017 American Academy of Neurology V. Sivakumar et al
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Congenital membrane causing unilateral hydrocephalus
Unilateral hydrocephalus is caused by foramen of Monro obstruction - due to neoplastic or inflammatory causes and congenital atresia or membrane occluding normal sized foramen [1]. Corpus callosal abnormalities appear to be the most common association. Surgical options include shunt placement in dilated ventricle, fenestration of septum pellucidum and neuroendoscopic fenestration of occluded foramen [2]. 1. Kumar R. Unilateral hydrocephalus in paediatric patients, a trial of endoscopic fenestration. Neurol India 1999; 47:282-5 2. Nigri F, Gobbi GN, da Costa Ferreira Pinto PH, Simões EL, Caparelli-Daquer EM. Hydrocephalus caused by unilateral foramen of Monro obstruction: A review on terminology. Surgical Neurology International. 2016;7(Suppl 12): S307-S313. doi: / ©2017 American Academy of Neurology V. Sivakumar et al
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