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December 1966

Adult Aqueductal Stenosis

Author Affiliations

From the departments of neurosurgery at the Boston Veterans Hospital and Massachusetts General Hospital, and the departments of radiology at the Boston Veterans Administration Hospital and Harvard University Health Services, Cambridge, Mass.

Arch Neurol. 1966;15(6):643-648. doi:10.1001/archneur.1966.00470180083009

HYDROCEPHALUS secondary to aqueductal stenosis is predominantly a disorder of childhood, though its occurrence in adults is well known.1-6 Pennybacker5 describes distinct "juvenile" and "adult" syndromes of aqueductal stenosis, but clinical manifestations vary widely. Asymptomatic cases have been found at routine postmortem examination. Kernohan and Sayre7 consider that "gliomas strategically placed in the aqueduct of Sylvius are in all probability the smallest tumors in the human body that lead to the death of the patient." More commonly the stenosis proves to be of nonneoplastic origin.8 Two patients we have seen during the past year fall in this latter category.

Report of Cases  CASE 1.—This 52-year-old canteen checker (BVAH#071060) noted onset of slowly progressive gait disturbance in 1958, shortly following the death of his mother, to whom he was closely attached. His wife complained of the patient's gradually failing ability to perform sexually. He

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