Acta Neurochirurgica

, Volume 159, Issue 8, pp 1445–1450 | Cite as

Bobble-head doll syndrome in an 80-year-old man, associated with a giant arachnoid cyst of the lamina quadrigemina, treated with endoscopic ventriculocystocisternotomy and cystoperitoneal shunt

  • Jorge Octavio Olvera-Castro
  • Hugo Morales-Briceño
  • Bayron Sandoval-Bonilla
  • David Gallardo-Ceja
  • Miguel Angel Venegas-Cruz
  • Eric Misael Estrada-Estrada
  • Marisol Contreras-Mota
  • Gerardo Guinto-Balanzar
  • Rabindranath Garcia-Lopez
Case Report - Neurosurgical Techniques


Bobble-head doll syndrome (BHDS) is a rare entity, characterized by antero-posterior head bobbing, which is of the type “yes–yes.” Less frequently, having a head movement of the type “no–no” is described. We report an unusual case of an 80-year-old man with a cystic mass of the lamina quadrigemina, extending to the posterior fossa. We conclude that ventriculocystocisternotomy associated with a cystoperitoneal shunt is an effective treatment for a symptomatic giant arachnoid cyst in the lamina quadrigemina.


Bobble-head doll syndrome Movement disorder Hydrocephalus Arachnoid cyst Ventriculocystocisternostomy Cystoperitoneal shunt 


Compliance with ethical standards


No funding was received for this research.

Conflict of interest


Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from patients relatives.


  1. 1.
    Albright L (1981) Treatment of bobble-head doll syndrome by transcallosal cystectomy. Neurosurgery 8:593–595CrossRefPubMedGoogle Scholar
  2. 2.
    Banerjee T (1977) Abnormal movements with hydrocephalus. Case report. J Neurosurg 46:674–676CrossRefPubMedGoogle Scholar
  3. 3.
    Bhattacharyya K, Deb S, Ghosh S et al (2014) Bobbling head in a young subject. Ann Indian Acad Neurol 17:371–373CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Ciricillo S, Cogen P, Harsh G et al (1991) Intracranial arachnoid cysts in children. A comparison of the effects of fenestration and shunting. J Neurosurg 74:230–235CrossRefPubMedGoogle Scholar
  5. 5.
    De Brito HJ, Santos Wandeck Henriques K, Pianetti Filho G et al (2007) Bobble-head doll syndrome associated with Dandy-Walker syndrome. Case report. J Neurosurg 107(3 Suppl Pediatrics):248–250Google Scholar
  6. 6.
    Decq P, Brugieres P, Le Guerinel C et al (1996) Percutaneous endoscopic treatment of suprasellar arachnoid cysts: ventriculocystostomy or ventriculocystocisternostomy. Technical note. Neurosurgery 84:696–701CrossRefGoogle Scholar
  7. 7.
    Dell S (1981) Further observations on the “bobble-head doll syndrome”. Short report. J Neurol Neurosurg Psychiatry 44:1046–1049CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Dias D, Castro F, Yared J et al (2014) Liliequist membrane: radiological evaluation, clinical and therapeutic implications. Radiol Bras 47:182–185CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Greenfield J, Mark M (2005) Endoscopic management of intracranial cysts. Neurosurg Focus 19(6):E7CrossRefPubMedGoogle Scholar
  10. 10.
    Gui S, Wang X, Zong X et al (2011) Suprasellar cysts: clinical presentation, surgical indications, and optimal surgical treatment. BMC Neurol 11:52CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Hagerbeuk E, Kloet A, Grotenhuis J et al (2005) Bobble-head doll syndrome successfully treated with an endoscopic ventriculocystocisternostomy. Case report and review of the literature. J Neurosurg 103(Pediatrics 3):253–259Google Scholar
  12. 12.
    Kindt G, Russo H (1974) A neuroanatomical basis for the bobble-head doll syndrome. J Neurosurg 41:720–723CrossRefPubMedGoogle Scholar
  13. 13.
    Lees A (2002) Odd and unusual movement disorders. J Neurol Neurosurg Psychiatry 72(Suppl I):i17–i21PubMedPubMedCentralGoogle Scholar
  14. 14.
    Maher C, Goumnerova L (2011) The effectiveness of ventriculocystocisternostomy for suprasellar arachnoid cysts. Clinical article. Neurosurg Pediatr 7:64–72CrossRefGoogle Scholar
  15. 15.
    Nellhaus G (1967) The bobble-head doll syndrome: a “tic” with neuropathologic basis. Pediatrics 40:250–253PubMedGoogle Scholar
  16. 16.
    Obenchain T, Becke D (1972) Head bobbing associated with a cyst of the third ventricle. Case report. J Neurosurg 37:457–459CrossRefPubMedGoogle Scholar
  17. 17.
    Pierre-Kahn A, Capelle L, Brauner R et al (1990) Presentation and management of suprasellar arachnoid cysts. Review of 20 cases. J Neurosurg 73:355–359CrossRefPubMedGoogle Scholar
  18. 18.
    Pollack I, Schor N, Martinez J et al (1995) Bobble-head doll syndrome and drop attacks in a child with a cystic choroid plexus papiloma of the third ventricle. Case report. J Neurosurg 83:729–732CrossRefPubMedGoogle Scholar
  19. 19.
    Reddy O, Gafoor J, Suresh B et al (2014) Bobble head doll syndrome: a rare case report. J Pediatr Neurosci 9:175–177CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Shih-Hung Y, Kulkarni A (2011) Successful treatment of tremor by endoscopic third ventriculostomy in an adolescent with obstructive hydrocephalus due to tectal glioma: case report. Childs Nerv Syst 27:1007–1010CrossRefGoogle Scholar
  21. 21.
    Sood S, Schumann M, Cakan N et al (2005) Endoscopic fenestration and coagulation shrinkage of suprasellar arachnoid cysts. Technical note. J Neurosurg 102(Pediatrics 1):127–133PubMedGoogle Scholar
  22. 22.
    Van Beijnum J, Hanlo P, Sen Han K et al (2006) Navigated laser-assisted endoscopic fenestration of a suprasellar arachnoid cyst in a 2-year-old child with bobble-head doll syndrome. Case report. J Neurosurg 104(5 Suppl Pediatrics):348–351PubMedGoogle Scholar
  23. 23.
    Wang J, Heier L, Souweidane M (2004) Advances in the endoscopic management of suprasellar arachnoid cyst in children. J Neurosurg 100(Pediatrics 5):418–426PubMedGoogle Scholar
  24. 24.
    Wiese J, Gentry L, Menezes A (1985) Bobble-head doll syndrome: review of the pathophyshiology and CSF dynamics. Pediatr Neurol 1:361–366CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Wien 2017

Authors and Affiliations

  • Jorge Octavio Olvera-Castro
    • 1
  • Hugo Morales-Briceño
    • 2
  • Bayron Sandoval-Bonilla
    • 1
    • 3
  • David Gallardo-Ceja
    • 1
  • Miguel Angel Venegas-Cruz
    • 1
  • Eric Misael Estrada-Estrada
    • 1
  • Marisol Contreras-Mota
    • 4
  • Gerardo Guinto-Balanzar
    • 1
    • 3
  • Rabindranath Garcia-Lopez
    • 1
    • 3
    • 5
  1. 1.Department of NeurosurgeryHospital de Especialidades del Centro Medico Nacional Siglo XXIMexico CityMexico
  2. 2.Department of NeurologyHospital de Especialidades del Centro Medico Nacional Siglo XXIMexico CityMexico
  3. 3.American British Cowdray Medical Center, Neurological Center ABCMexico CityMexico
  4. 4.Department of AnesthesiologyHospital de Especialidades del Centro Medico Nacional Siglo XXIMexico CityMexico
  5. 5.Hospital Angeles LomasConsultorio 525, Torre de EspecialidadesHuixquilucanMexico

Personalised recommendations