{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T04:37:53Z","timestamp":1745469473075,"version":"3.40.4"},"reference-count":29,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2011,1,1]],"date-time":"2011-01-01T00:00:00Z","timestamp":1293840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2011,1,1]],"date-time":"2011-01-01T00:00:00Z","timestamp":1293840000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatr Neurosurg"],"published-print":{"date-parts":[[2011]]},"abstract":"<jats:p>In most of the children with posthemorrhagic hydrocephalus (PHH), multidisciplinary follow-up is performed, with the focus on consequences of prematurity, cerebral palsy (CP) and hydrocephalus. A large fourth ventricle is common in these children but imaging performed in order to document ventricles and tissue damage is not oriented to exclude coexisting rare pathologies. We report a 3-year-old child with spastic CP, secondary to prematurity and PHH. A ventriculoperitoneal shunt was inserted at the age of 2 months. On follow-up imaging the child demonstrated well-drained supratentorial ventricles with a persistent large fourth ventricle. Because of a neurological change in spasticity and new-onset torticollis, a repeat MRI was performed, suggesting a cystic, nonenhancing lesion of the fourth ventricle. The surgical exploration revealed a large dermoid of the fourth ventricle. We analyze the differential diagnosis of a clinically significant large fourth ventricle in a shunted child with PHH and CP. This includes conditions without pressure in the posterior fossa such as tissue loss due to cerebellar atrophy, or pathologies causing a true increase in pressure of the fourth ventricle (isolated fourth ventricle, cystic lesions and neoplasms of the fourth ventricle). Neurologically compromised children pose additional challenges in reaching a definitive diagnosis and hence require a careful regular assessment of their clinical status with additional well-timed imaging with appropriate protocols to allow appropriate treatment when indicated and to avoid morbidity due to delayed diagnosis. We present a rare coexistence of a dermoid tumor within the fourth ventricle in a CP child with PHH and express the dilemmas associated with its management.<\/jats:p>","DOI":"10.1159\/000325074","type":"journal-article","created":{"date-parts":[[2011,8,23]],"date-time":"2011-08-23T06:47:03Z","timestamp":1314082023000},"page":"60-65","source":"Crossref","is-referenced-by-count":2,"title":["Unusual Case of \u2018Trapped Fourth Ventricle\u2019 in a Child with Posthemorrhagic Hydrocephalus \u2013 Lessons Learnt"],"prefix":"10.1159","volume":"47","author":[{"given":"Suhas","family":"Udayakumaran","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liana","family":"Beni Adani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2011,8,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1136%2Ffn.86.2.F72"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1053%2Fsiny.2001.0047"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1007%2Fs00431-007-0647-0"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1111%2Fj.1651-2227.1999.tb00068.x"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1007%2Fs002470050085"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1038%2Fsj.jp.7210941"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1542%2Fpeds.102.6.e62"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1177%2F088307380201700502"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1007%2Fs00234-003-1067-0"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1177%2F0883073809338067"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1542%2Fpeds.2005-0556"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016%2F0387-7604%2895%2900079-Q"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1002%2Fmrdd.1032"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016%2F0090-3019%2890%2990170-T"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1007%2FBF01577734"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1136%2Fjnnp.15.1.1"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.3171%2Fjns.1977.47.1.0012"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016%2FS0090-3019%2801%2900542-0"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1007%2Fs003300000544"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1007%2Fs00701-009-0203-y"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1002%2Fana.410020504"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1227%2F00006123-198904000-00012"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1007%2FBF00301020"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1007%2FBF00345926"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016%2FS0720-048X%2801%2900432-6"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1148%2Fradiol.2393050823"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1007%2Fs00701-008-0152-x"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1007%2Fs00247-006-0202-6"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1007%2Fs00381-003-0856-4"}],"container-title":["Pediatric Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/325074","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/325074","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T19:36:48Z","timestamp":1745437008000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000325074"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2011,9,1]]},"published-print":{"date-parts":[[2011,9,13]]}},"URL":"https:\/\/doi.org\/10.1159\/000325074","archive":["Portico"],"relation":{},"ISSN":["1016-2291","1423-0305"],"issn-type":[{"type":"print","value":"1016-2291"},{"type":"electronic","value":"1423-0305"}],"subject":[],"published":{"date-parts":[[2011]]}}}