Adult idiopathic occlusion of the foramina of monro: Diagnostic tools and therapy

BACKGROUND AND PURPOSE The bilateral foramina of Monro occlusion is an extremely rare event in adults. To date, only six cases of adult hydrocephalus due to idiopatic obstruction of the bilateral foramina of Monro (including our patient) have been reported. METHODS The authors describe the case of a 41-year-old man with a recent onset of motor hindrance which occurred specially while jumping or playing basketball, together with recent memory impairment, deceleration of thought, and asthenia. The patient was studied with fast spin echo (FSE) and steady-state free precession high-resolution 3D sequences (SSFP) together with a ventricular infusion test, and subsequently treated with endoscopic foraminoplasty. RESULTS The presenting symptoms completely resolved. Follow-up magnetic resonance imaging (MRI) showed the patency of right Monro foramen, with gradually decreasing ventricular size and increase of subarachnoid spaces. CONCLUSIONS These patients should be accurately studied before treatment. In fact, MRI has made it possible to know what a surgeon will exactly find on the operative field. In that way a correct surgical planning can be achieved.