Skip to main content

Disproportionately large communicating fourth ventricle resulting from adjustable valve shunt in an infant


Disproportionately large communicating fourth ventricle (DLCFV) is usually experienced in adults with no previous experience of shunting. We present a case of an infant with an enlarged fourth ventricle similar to isolated fourth ventricle (IFV) which appeared after shunting. The patient’s brain stem symptoms and the abnormal appearance of the fourth ventricle were dramatically ameliorated simply by reducing the opening pressure of the adjustable valve of the ventriculo-peritoneal shunt. The present case suggests that in the present era, with adjustable or programmable valve shunt a common procedure, DLCFV may occur, at least temporarily, even in infants and even after shunting.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3


  1. Hall TR, Choi A, Schellinger D, Grant EG (1992) Isolation of fourth ventricle causing transtentorial herniation: neurosonographic findings in premature infants. AJR Am J Roentgenol 159:811–815

    PubMed  CAS  Google Scholar 

  2. Hamada H, Hayashi N, Kurimoto M, Endo S (2005) Endoscopic aqueductal stenting via the fourth ventricle under navigating system guidance: technical note. Neurosurgery 56(1 Suppl):E206

    PubMed  Article  Google Scholar 

  3. Shose Y, Nogaki H, Kamikawa S (1991) Disproportionately large, communicating fourth ventricle. Case report. Neurol Med Chir (Tokyo) 31:1003–1007 Japanese

    Article  CAS  Google Scholar 

  4. Hagihara N, Sakata S (2007) Disproportionately large communicating fourth ventrile with syringomyelia. Case report. Neurol Med Chir (Tokyo) 47:278–281

    Article  Google Scholar 

  5. Scotti G, Musgrave MA, Fitz CR, Harwood-Nash DC (1980) The isolated fourth ventricle in children: CT and clinical review of 16 cases. AJR Am J Roentgenol 135:1233–1238

    PubMed  CAS  Google Scholar 

  6. Kuroki T, Matsumoto M, Ohishi H et al (1992) Disproportionately large, communicating fourth ventricle: report of 4 cases. No Shinkei Geka 20:707–711 Japanese

    PubMed  CAS  Google Scholar 

  7. Montgomery CT, Winfield JA (1993) Fourth ventricular entrapment caused by rostrocaudal herniation following shunt malfunction. Pediatr Neurosurg 19:209–214

    PubMed  Article  CAS  Google Scholar 

Download references

Conflict of interest


Author information

Authors and Affiliations


Corresponding author

Correspondence to Hiroyuki Katano.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Katano, H., Matsuo, S. & Yamada, K. Disproportionately large communicating fourth ventricle resulting from adjustable valve shunt in an infant. Acta Neurol Belg 112, 91–93 (2012).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • Disproportionately large communicating fourth ventricle
  • Isolated fourth ventricle
  • Adjustable valve shunt
  • Programmable valve shunt