{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:25:57Z","timestamp":1761823557715,"version":"3.40.4"},"reference-count":14,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>Isolated enlargement of the fourth ventricle, or \u2018encysted\u2019 fourth ventricle is a rare late complication following shunt insertion of the lateral ventricles for hydrocephalus. Caudal and rostral obstruction of the fourth ventricle and its subsequent dilation results in compression of adjacent cerebellum and brain stem structures; treatment with further shunt insertion directly to the fourth ventricle is invariably successful. There is potential for diagnostic delay, when clinical symptoms and signs of cerebellar and brain stem compromise are unrecognised or attributed to other factors, and attention on the CT is focused on the lateral ventricular system and the already existing \u00a0ventriculoperitoneal shunt, which will appear unchanged from previous scans. We report two cases with isolated fourth ventricular obstruction and review the literature to highlight the importance of recognising this condition.<\/jats:p>","DOI":"10.1136\/bcr-2013-008791","type":"journal-article","created":{"date-parts":[[2013,4,4]],"date-time":"2013-04-04T08:13:29Z","timestamp":1365063209000},"page":"bcr2013008791","source":"Crossref","is-referenced-by-count":10,"title":["The isolated fourth ventricle"],"prefix":"10.1136","volume":"2013","author":[{"given":"Khalid","family":"Ali","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ravindra","family":"Nannapaneni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khalid","family":"Hamandi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,4,3]]},"reference":[{"key":"2025042702314776000_2013.apr03_1.bcr2013008791.1","doi-asserted-by":"crossref","unstructured":"Pearce JMS . Parinaud's syndrome. J Neurol Neurosurg Psychiatr 2005;2013:99.","DOI":"10.1136\/jnnp.2003.031310"},{"key":"2025042702314776000_2013.apr03_1.bcr2013008791.2","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1007\/s00415-011-5919-y","article-title":"Henri Parinaud (1844\u20131905)","volume":"2013","author":"Ouvrier","year":"2011","journal-title":"J Neurol"},{"key":"2025042702314776000_2013.apr03_1.bcr2013008791.3","unstructured":"UK shunt registry. http:\/\/www.neuroscience.cam.ac.uk"},{"key":"2025042702314776000_2013.apr03_1.bcr2013008791.4","unstructured":"Ropper A Samuels M . Principles of neurology. 9thedn. 2009:591."},{"key":"2025042702314776000_2013.apr03_1.bcr2013008791.5","first-page":"112","article-title":"The diagnosis and treatment of hydrocephalus due to occlusion of the foramina of Magendie and Luschka","volume":"2013","author":"Dandy","year":"1921","journal-title":"Surge Gynecol Obstet"},{"key":"2025042702314776000_2013.apr03_1.bcr2013008791.6","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1159\/000120733","article-title":"Fourth ventricular entrapment caused by rostrocaudal herniation following shunt malfunction","volume":"2013","author":"Montgomery","year":"1993","journal-title":"Pediatr Neurosurg"},{"key":"2025042702314776000_2013.apr03_1.bcr2013008791.7","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1227\/01.NEU.0000130444.71677.BC","article-title":"Endocsopic aqueductoplasty and interventriculostomy for the treatment of isolated fourth ventricle in children","volume":"2013","author":"Fritisch","year":"2004","journal-title":"Neurosurgery"},{"key":"2025042702314776000_2013.apr03_1.bcr2013008791.8","first-page":"373","article-title":"Simplified aqueductal stenting for isolated fourth ventricle using a small-caliber flexible endoscope in a patient with neuro-coccidiomycosis: technical case report","volume":"2013","author":"Little","year":"2010","journal-title":"Neurosurgery"},{"key":"2025042702314776000_2013.apr03_1.bcr2013008791.9","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.3171\/jns.2000.92.6.1036","article-title":"Neuroendoscopic stent placement procedure for isolated fourth ventricle after ventricular shunt placement","volume":"2013","author":"Shin","year":"2000","journal-title":"J Neurosurg"},{"key":"2025042702314776000_2013.apr03_1.bcr2013008791.10","doi-asserted-by":"crossref","first-page":"73","DOI":"10.3171\/ped.2005.103.1.0073","article-title":"Endoscopic options in the management of isolated fourth ventricles","volume":"2013","author":"Mohanty","year":"2005","journal-title":"J Neurosurg (Pediatrics 1)"},{"issue":"4 Suppl pediatrics","key":"2025042702314776000_2013.apr03_1.bcr2013008791.11","first-page":"275","article-title":"Endoscopic aqueduct stent placement for the treatment of a trapped fourth ventricle","volume":"2013","author":"Sagan","year":"2006","journal-title":"J Neurosurg"},{"issue":"1 Suppl","key":"2025042702314776000_2013.apr03_1.bcr2013008791.12","first-page":"21","article-title":"Endoscopic aqueductoplasty and placement of a stent in the cerebral aqueduct in the management of isolated fourth ventricle in children","volume":"2013","author":"Cinalli","year":"2006","journal-title":"J Neurosurg"},{"key":"2025042702314776000_2013.apr03_1.bcr2013008791.13","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s003810050031","article-title":"Complications after shunting isolated IV ventricles","volume":"2013","author":"Eder","year":"1997","journal-title":"Childs Nerv Sys"},{"key":"2025042702314776000_2013.apr03_1.bcr2013008791.14","first-page":"679","article-title":"Clinical evaluation of an isolated fourth ventricle","volume":"2013","author":"Kojima","year":"1988","journal-title":"No To Shinkei"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2013-008791","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T09:31:59Z","timestamp":1745746319000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2013-008791"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,4,3]]},"references-count":14,"alternative-id":["10.1136\/bcr-2013-008791"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2013-008791","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2013,4,3]]}}}