Atormac
Neurology India
menu-bar5 Open access journal indexed with Index Medicus
  Users online: 1944  
 Home | Login 
About Editorial board Articlesmenu-bullet NSI Publicationsmenu-bullet Search Instructions Online Submission Subscribe Videos Etcetera Contact
  Navigate Here 
 Search
 
  
 Resource Links
  »  Similar in PUBMED
 »  Search Pubmed for
 »  Search in Google Scholar for
  »  Article in PDF (292 KB)
  »  Citation Manager
  »  Access Statistics
  »  Reader Comments
  »  Email Alert *
  »  Add to My List *
* Registration required (free)  

 
  In this Article
 »  References

 Article Access Statistics
    Viewed1649    
    Printed58    
    Emailed0    
    PDF Downloaded54    
    Comments [Add]    
    Cited by others 1    

Recommend this journal

 


 
Table of Contents    
CORRESPONDENCE
Year : 2011  |  Volume : 59  |  Issue : 2  |  Page : 322

Bilateral transtentorial herniation and isolated fourth ventricle: A scientific note


Department of Neurosurgery, Amrita Institute of Medical Sciences, Ponekkara P.O, Kochi- 682041, India

Date of Submission12-Jan-2011
Date of Decision13-Jan-2011
Date of Acceptance20-Jan-2011
Date of Web Publication7-Apr-2011

Correspondence Address:
Suhas Udayakumaran
Department of Neurosurgery, Amrita Institute of Medical Sciences, Ponekkara P.O, Kochi- 682041
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.79166

Rights and Permissions



How to cite this article:
Udayakumaran S. Bilateral transtentorial herniation and isolated fourth ventricle: A scientific note. Neurol India 2011;59:322

How to cite this URL:
Udayakumaran S. Bilateral transtentorial herniation and isolated fourth ventricle: A scientific note. Neurol India [serial online] 2011 [cited 2020 May 27];59:322. Available from: http://www.neurologyindia.com/text.asp?2011/59/2/322/79166


Sir,

We read with interest the letter to the editor by Novak et al. [1] and congratulate them for highlighting a rare clinical entity. The authors suggested that to the best of their knowledge their case was probably the first description of this rare phenomenon. They have been regretfully incomplete in their literature search, especially the most recent publications by our group. [2],[3],[4]

Transtentorial uncal herniation, in its chronic form, has been reported in only a few case reports with some unclear clinical implications. We had described this rare finding in 2 children, secondary to 2 diverse etiologies: as a sequela of a posterior fossa shunt ( secondary to shunt overdrainage) [3] and as a developmental association (secondary to CSF loss through the open spinal defect) with a Chiari II malformation. [4] We proposed a unified hypothesis that this phenomenon of chronic uncal herniation can be due to the pressure gradient that develops between supratentorial compartment and the infratentorial compartment. [2] The patient reported by these authors had posterior fossa shunt and bilateral transtentorial herniation of chronic nature ("living patient"), thus supporting our postulation.

The management strategies suggested by us include [3],[4] : (1) ruling out shunt malfunction in cases of simultaneous presence of supratentorial ventriculoperitoneal shunt; (2) upgrading the valve of the infratentorial shunt in situations otherwise when overdrainage is suspected; and (3) careful follow-up whenever in asymptomatic patients.

 
 » References Top

1.Novak L, Pataki I, Nagy A, Berenyi E. Bilateral transtentorial herniation and isolated fourth ventricle: A scientific note. Neurol India 2010;58:953-4.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Udayakumaran S, Bensira L, Constantini S. Chronic uncal herniation-developmental and acquired: Postulating a unified hypothesis. In: Di Rocco C, editor. 38th Annual Meeting of the International Society for Pediatric Neurosurgery; October 31 to November 4, 2010; Jeju, South Korea. Berlin: Springer; Childs Nerv Syst 2010;26:1435-76.  Back to cited text no. 2
    
3.Udayakumaran S, Ben Sira L, Constantini S. Chronic uncal herniation secondary to posterior fossa shunting: Case report and literature review. Childs Nerv Syst 2010;26:267-71.  Back to cited text no. 3
[PUBMED]  [FULLTEXT]  
4.Udayakumaran S, Ben Sira L, Constantini S. Temporal lobe herniation of developmental origin: A novel radiological association with open spina bifida and Chiari II malformation. Childs Nerv Syst 2010;26:277-8.  Back to cited text no. 4
    



This article has been cited by
1 Authorsę reply
Novak, L., Pataki, I., Nagy, A., Berenyi, E.
Neurology India. 2011; 59(2): 323
[Pubmed]



 

Top
Print this article  Email this article
   
Online since 20th March '04
Published by Wolters Kluwer - Medknow