{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:57:39Z","timestamp":1787169459844,"version":"build-2736575974"},"reference-count":41,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Tetraventricular hydrocephalus is a common presentation of communicating hydrocephalus. Conversely, cases with noncommunicating etiology impose a diagnostic challenge and are often neglected and underdiagnosed. Herein, we present a review of literature for clinical, diagnostic, and surgical aspects regarding noncommunicating tetrahydrocephalus caused by primary fourth ventricle outlet obstruction (FVOO), illustrating with a case from our service.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We performed a research on PubMed database crossing the terms \u201cFVOO,\u201d \u201ctetraventriculomegaly,\u201d and \u201chydrocephalus\u201d in English. Fifteen articles (a total of 34 cases of primary FVOO) matched our criteria and were, therefore, included in this study besides our own case.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Most cases presented in adulthood (47%), equally divided between male and female. Clinical presentation was unspecific, commonly including headache, nausea, and dizziness as symptoms (35.29%, 21.57%, and 9.80%, respectively), with ataxic gait (65%) and papilledema (40%) being the most frequent signs. MRI and CT were the imaging modalities of choice (11 patients each), often associated with CSF flow studies, such as cine MRI and CT ventriculogram. Endoscopic third ventriculostomy (ETV) was both the most popular and effective surgical approach (50.85% of cases, with 18.91% of recurrence) followed by ventricle-peritoneal shunt (16.95% of patients, 23.0% of recurrence).<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n FVOO stands for a poorly understood etiology of noncommunicating tetrahydrocephalus. With the use of ETV, these cases, once hopeless, had its morbimortality and recurrence reduced greatly. Therefore, its suspicion and differentiation from other forms of tetrahydrocephalus can improve its natural course, reinforcing the importance of its acknowledgment.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_635_2021","type":"journal-article","created":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T05:57:19Z","timestamp":1634709439000},"page":"519","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Tetraventricular noncommunicating hydrocephalus: Case report and literature review"],"prefix":"10.25259","volume":"12","author":[{"given":"Magno Rocha Freitas","family":"Rosa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thain\u00e1 Zanon","family":"Cruz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo Vasconcelos","family":"Magalh\u00e3es Junior","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavio","family":"Nigri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2021,10,19]]},"reference":[{"key":"10.25259\/SNI_635_2021\/ref-1","doi-asserted-by":"crossref","first-page":"672","DOI":"10.3171\/jns.1971.35.6.0672","article-title":"Hydrocephalus due to membranous obstruction of the fourth ventricle","volume":"35","author":"Amacher","year":"1971","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_635_2021\/ref-2","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1007\/s003830050676","article-title":"Intestinal volvulus-a rare complication of ventriculoperitoneal shunt","volume":"15","author":"Bal","year":"1999","journal-title":"Pediatr Surg Int"},{"key":"10.25259\/SNI_635_2021\/ref-3","doi-asserted-by":"crossref","first-page":"S1150","DOI":"10.4103\/2152-7806.196930","article-title":"Transanal presentation of a distal ventriculoperitoneal shunt catheter: Management of bowel perforation without laparotomy","volume":"7","author":"Bales","year":"2016","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_635_2021\/ref-4","doi-asserted-by":"crossref","first-page":"97","DOI":"10.4103\/0976-3147.143212","article-title":"Vaginal extrusion of a ventriculo-peritoneal shunt catheter in an adult","volume":"6","author":"Bonfield","year":"2015","journal-title":"J Neurosci Rural Pract"},{"key":"10.25259\/SNI_635_2021\/ref-5","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.pediatrneurol.2005.05.021","article-title":"Failure of cerebrospinal fluid shunts: Part II: Overdrainage, loculation, and abdominal complications","volume":"34","author":"Browd","year":"2006","journal-title":"Pediatr Neurol"},{"key":"10.25259\/SNI_635_2021\/ref-6","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.pediatrneurol.2005.05.020","article-title":"Failure of cerebrospinal fluid shunts: Part I: Obstruction and mechanical failure","volume":"34","author":"Browd","year":"2006","journal-title":"Pediatr Neurol"},{"key":"10.25259\/SNI_635_2021\/ref-7","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1007\/s002340050888","article-title":"Blake\u2019s pouch cyst: An entity within the Dandy-Walker continuum","volume":"42","author":"Calabro","year":"2000","journal-title":"Neuroradiology"},{"key":"10.25259\/SNI_635_2021\/ref-8","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1007\/s007010170083","article-title":"Obstruction of Magendie\u2019s and Luschka\u2019s foramina. 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