Isolated fourth ventricle treated with fourth ventricle shunt connected to the supratentorial shunt via a Y-connector: Two case reports

Isolated fourth ventricular (IFV) is an exceptionally uncommon medical condition that exhibits the distinctive feature of an anomalous structure within the fourth ventricle of the cerebral region. The aetiology of this anomaly is postulated to be a consequence of diverse pathological and congenital elements that impede the physiological circulation of cerebrospinal fluid (CSF) within the fourth ventricle. The obstruction presence is observed in both the ingress and egress routes of the ventricle, resulting in a modified cerebrospinal fluid (CSF) dynamics within this particular cerebral area. The investigation was conducted at Dr. Soetomo Academic General Hospital's Neurosurgery Department in Surabaya, Indonesia. Two patients with an isolated fourth ventricle were extracted from our database, and each of their cases was examined. The authors retrospectively examined patient demographics, clinical findings, radiology results, operative procedures, and postoperative complications. Two patients who underwent a Y-connector-connected fourth ventricle shunt to supratentorial shunt and survived the procedure. There were no significant postoperative complications (sepsis, reoperation, or death). The fourth ventricle shunt with Y-connector to supratentorial shunt is technically feasible and an efficacious treatment modality for IFV. In a context with limited resources, it may be an option.