# Congenital Aqueductal Stenosis — GCMD Library living collection

Everything in the library about congenital aqueductal stenosis — built automatically from dossiers that name it.

Updated: n/a · 4 episodes · 59 cited statements

## Episodes
### Fundamentals
- [2024 Fetal Care Center Frontiers in Fetal Neurology Day 1 - Introduction](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-introduction-9233) — video · 2:56 · [machine version](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-introduction-9233.md)

### Surgical Management
- [2024 Fetal Care Center Frontiers in Fetal Neurology Day 1 - Dr. Jesse Skoch](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234) — video · 19:51 · [machine version](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234.md)

### Evidence & Research
- [2024 Fetal Care Center Frontiers in Fetal Neurology Day 1 - Dr. Charu Venkatesen](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232) — video · 12:51 · [machine version](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232.md)

### Case-Based Learning
- [2024 Fetal Care Center Frontiers in Fetal Neurology Day 1 - Hour 1 Q&A](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240) — video · 9:06 · [machine version](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240.md)

## Chapters
- [0:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=0) Introduction to Congenital Aqueductal Stenosis and Ventriculomegaly (Ep 1)
- [3:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=180) Etiology, Incidence, and Literature Review of Outcomes (Ep 1)
- [6:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=360) Cincinnati Study: Isolated versus Complex CAS Outcomes (Ep 1)
- [9:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=540) Future Directions and Collaborative Research Initiatives (Ep 1)
- [11:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=660) Acknowledgments and Closing (Ep 1)
- [0:41](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-introduction-9233?t=41) Conference Welcome and Schedule Overview (Ep 2)
- [0:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=0) Introduction and speaker handoff (Ep 3)
- [0:16](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=16) Historical development of endoscopic third ventriculostomy (Ep 3)
- [4:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=240) Modern ETV surgical technique demonstration (Ep 3)
- [7:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=420) Age-dependent success rates and the ETV Success Score (Ep 3)
- [11:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=660) Failure mechanisms and age-related challenges (Ep 3)
- [13:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=780) Heterogeneity of aqueductal stenosis and neurologic outcomes (Ep 3)
- [15:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=900) Safety comparison: ETV versus shunt dependency (Ep 3)
- [17:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=1020) Clinical decision-making framework for timing (Ep 3)
- [18:30](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=1110) Adjunctive techniques and future directions (Ep 3)
- [0:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=0) Outcomes in isolated versus complex congenital aqueductal stenosis (Ep 4)
- [1:50](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=110) Technical aspects and timing of fetal ETV (Ep 4)
- [3:54](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=234) Timeline for human fetal ETV trials (Ep 4)
- [4:44](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=284) Acetazolamide use and timing of postnatal intervention (Ep 4)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- "The complex category in the Children's Hospital study included any case with any other anomaly, including genetic anomalies (aneuploidies, trisomy 13/18), extracranial findings, and syndromic findings, creating a heterogeneous group." (clinical) [Ep 4 · 0:47](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=47)
- "Current counseling practice tends to combine isolated aqueductal stenosis cases (without suspected genetic cause) with complex cases in a broad-strokes approach, which may not be the appropriate approach." (opinion) [Ep 4 · 0:47](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=47)
- "Conventional endoscopes for ETV are usually about 6 millimeters in diameter." (clinical) [Ep 4 · 2:07](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=127)
- "For fetal ETV cases, 2.4 millimeter scopes are being used in clinical studies." (host_summary) [Ep 4 · 2:07](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=127)
- "The fetal ETV scope is a 2.4 mm sharp-tip fetoscope with a 1.3 mm camera and a working channel, the same equipment used for placing tracheal balloons in CDH fetuses." (clinical) [Ep 4 · 2:22](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=142)
- "The proposed gestational age for fetal ETV in phase one human studies is 24-25 weeks, following diagnosis around 20-21 weeks and genetic workup, similar to timing for spina bifida repair." (clinical) [Ep 4 · 3:11](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=191)
- "Intervention between 25 and 30 weeks gestational age is considered acceptable for cases with delayed diagnosis, allowing time for brain recovery in utero." (opinion) [Ep 4 · 3:11](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=191)
- "The fetal ETV trial requires an FDA IND (Investigational New Drug application) because it is a risky procedure, even though no drug is used and no device is left behind." (guideline) [Ep 4 · 4:03](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=243)
- "The goal is to begin a pilot study for safety and feasibility of fetal ETV next year, involving collaboration between fetal surgery and neurosurgery teams." (clinical) [Ep 4 · 4:03](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=243)
- "Acetazolamide can reduce CSF production by approximately 15% at best." (clinical) [Ep 4 · 5:29](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=329)
- "Acetazolamide may allow delaying intervention by one to two months in borderline, slowly progressing cases to reach a better category for ETV." (opinion) [Ep 4 · 5:29](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=329)
- "Acetazolamide has sufficient safety experience and electrolyte monitoring protocols to be used as a temporizing measure in appropriate patients." (clinical) [Ep 4 · 5:29](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=329)
- "Acetazolamide cannot be expected to be a game changer in rapidly progressing hydrocephalus cases." (opinion) [Ep 4 · 5:29](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=329)
- "Early postnatal ETV has a high failure rate in newborns with congenital aqueductal stenosis." (clinical) [Ep 4 · 5:29](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=329)
- "In a study by Rus, type 2 slowly progressive hydrocephalus patients treated with delayed ETV had the same neurologic outcomes as patients who were shunted earlier." (epidemiological) [Ep 4 · 5:29](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=329)
- "For stable postnatal patients not showing signs of rapid progression, there is no convincing data that earlier intervention is always better in a linear fashion." (opinion) [Ep 4 · 5:29](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=329)
- "For patients showing active progression with increasing pressure and damage, sooner intervention is better than waiting." (opinion) [Ep 4 · 5:29](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=329)
- "The primary benefit of fetal ETV may be developmental changes rather than preventing procedure failure, as many fetal ETV patients may still experience postnatal failure." (opinion) [Ep 4 · 5:29](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=329)
- "In postnatal treatment, the timing of intervention (earlier versus slightly later) is probably not as critical because the damage is already done and the condition is stable." (opinion) [Ep 4 · 8:12](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=492)
- "In fetal cases, timing is very critical because early intervention can potentially avoid pressure and allow better brain development." (opinion) [Ep 4 · 8:12](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=492)
- "The ETV fenestration can close in both neonates and fetuses, which is a concern for fetal intervention." (clinical) [Ep 4 · 8:12](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=492)
- "Maintaining decompression for 6-7 weeks in utero without pressure is beneficial even if postnatal redo ETV or shunt placement is needed, because the brain will have developed better." (opinion) [Ep 4 · 8:12](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=492)
- "The goal of fetal ETV is not to completely fix the hydrocephalus but to temporize and achieve better brain development, even if the intervention is temporary." (opinion) [Ep 4 · 8:12](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-hour-1-q-a-9240?t=492)
- "Day 1 session 1 (12:00-1:00 PM) covers congenital aqueductal stenosis, including outcomes and fetal MRI findings" — Charivenka Tayson (host_summary) [Ep 2 · 0:41](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-introduction-9233?t=41)
- "Day 1 session 2 (1:00-2:00 PM) addresses uncertainties in neurological diagnoses, including fetal intracranial hemorrhage, genetic conditions with brain malformations, and palliative care in fetal counseling" — Charivenka Tayson (host_summary) [Ep 2 · 0:41](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-introduction-9233?t=41)
- "Day 2 (October 9th) will cover fetal therapeutics, treatment of tuberous sclerosis, and toxic/environmental exposures affecting brain development" — Charivenka Tayson (host_summary) [Ep 2 · 0:41](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-introduction-9233?t=41)
- "Doctor Jessie Scotch will discuss fetal MRI findings for congenital aqueductal stenosis" — Charivenka Tayson (host_summary) [Ep 2 · 0:41](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-introduction-9233?t=41)
- "Doctor Don Gano from UCSF will discuss fetal intracranial hemorrhage" — Charivenka Tayson (host_summary) [Ep 2 · 0:41](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-introduction-9233?t=41)
- "Doctor Sonika Agarwal from CHOP will review genetic conditions and brain malformations" — Charivenka Tayson (host_summary) [Ep 2 · 0:41](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-introduction-9233?t=41)
- "Doctor Donna Maria Corteso will review the role of palliative care in fetal counseling" — Charivenka Tayson (host_summary) [Ep 2 · 0:41](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-introduction-9233?t=41)
- "Congenital aqueductal stenosis accounts for 5-20% of congenital hydrocephalus etiology, with approximately 600-1500 cases per year in the United States." — Jesse Skoch (epidemiological) [Ep 3 · 0:16](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=16)
- "Walter Dandy in the 1920s used a crude cystoscope to burn choroid plexus in hydrocephalic patients, with 24 out of 25 patients dying of complications." — Jesse Skoch (clinical) [Ep 3 · 2:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=120)
- "Dr. Mixer in 1923 is credited with the modern version of ETV involving fenestration of the floor of the third ventricle using a urethroscope." — Jesse Skoch (clinical) [Ep 3 · 3:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=180)
- "Scarf et al. in 1936 published a series of 20 ETV cases with 10 showing long-term improvement, 7 failures, and 3 immediate post-surgical deaths." — Jesse Skoch (clinical) [Ep 3 · 3:30](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=210)
- "ETV technology reached its modern form in the 1980s with advances in camera and endoscope technology, after being relatively quiescent from the mid-1930s due to the invention of VP shunt pressure-regulated valves in the 1950s." — Jesse Skoch (clinical) [Ep 3 · 4:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=240)
- "Serial slow dilation with balloon catheters (such as 3 French Fogarty catheters) can successfully open the majority of the accessible floor of the third ventricle, even in patients with narrow third ventricles." — Jesse Skoch (clinical) [Ep 3 · 5:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=300)
- "Making the ETV ostomy as large as possible is important in young children because it helps fight against closure in the growing infant brain." — Jesse Skoch (opinion) [Ep 3 · 6:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=360)
- "The ETV Success Score assigns 30 points for aqueductal stenosis etiology and 50 points for age greater than 10 years, with points translating directly to percentage success rates." — Jesse Skoch (clinical) [Ep 3 · 9:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=540)
- "Patients with aqueductal stenosis who are greater than 10 years old have an 80% chance of ETV success, while those less than 1 month old have success rates in the 30-50% range." — Jesse Skoch (clinical) [Ep 3 · 10:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=600)
- "ETV procedures carry risks including hemorrhage, injury to the basilar artery, damage to the fornix (which can cause memory loss), and procedure failure." — Jesse Skoch (clinical) [Ep 3 · 10:30](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=630)
- "Successful ETV patients typically do not show the same degree of ventricular reduction as shunted patients, but developmental outcomes can be very good." — Jesse Skoch (clinical) [Ep 3 · 12:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=720)
- "A visible CSF jet stream (appearing black on sagittal MRI) through the ETV ostomy is a reassuring sign of patency, though not required for success." — Jesse Skoch (clinical) [Ep 3 · 12:30](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=750)
- "ETV failures occur through four mechanisms: ostomy closure, ostomy narrowing, patent ostomy with membrane formation elsewhere in the third ventricle or basilar cisterns, or insufficient CSF diversion possibly due to mixed communicating hydrocephalus." — Jesse Skoch (clinical) [Ep 3 · 13:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=780)
- "The Toronto group's large study showed that infants less than 1 month old fare poorly with ETV outcomes over time, with a big improvement in success rates at the 6-month age mark." — Jesse Skoch (host_summary) [Ep 3 · 14:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=840)
- "Mohammadi et al. showed that pre-term versus post-term status makes a significant difference in ETV outcomes, with corrected age being important to consider in premature babies." — Jesse Skoch (host_summary) [Ep 3 · 14:30](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=870)
- "According to Rhodes et al., congenital acute aqueductal stenosis (big ventricles from birth with progression) has better neurologic outcomes with shunting than with ETV, while chronic slowly progressive hydrocephalus shows no difference between procedures." — Jesse Skoch (host_summary) [Ep 3 · 15:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=900)
- "A 2011 meta-analysis showed ETV has a permanent morbidity rate of 2.4% and mortality of 0.21%." — Jesse Skoch (host_summary) [Ep 3 · 16:30](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=990)
- "Shunting has an in-hospital mortality of 0.3-0.8%, but Norwegian longitudinal studies over 40 years showed 48% overall mortality with 8% attributed to shunt failures and shunt-related issues." — Jesse Skoch (host_summary) [Ep 3 · 17:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=1020)
- "If an ETV works and shows success at 6 months to 1 year, very few patients will have long-term delayed complications, unlike the constantly ticking time bomb of shunt dependency." — Jesse Skoch (clinical) [Ep 3 · 17:30](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=1050)
- "If a clinician is not comfortable letting a patient go for two weeks without follow-up ultrasound or examination, that is a red flag warning sign that the patient needs shunting rather than continued observation." — Jesse Skoch (opinion) [Ep 3 · 18:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=1080)
- "Stented ETV using hardware to hold the ostomy open has not panned out well because foreign body reactions can occur at any time in the patient's life, similar to shunt failures." — Jesse Skoch (clinical) [Ep 3 · 18:30](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=1110)
- "Dr. Warf's sub-Saharan African study showed a 30% improvement in ETV success when combined with choroid plexus cauterization, but meta-analysis of other published studies has not replicated those numbers in larger datasets." — Jesse Skoch (host_summary) [Ep 3 · 19:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-jesse-skoch-9234?t=1140)
- "Ventriculomegaly is the most common CNS abnormality identified on fetal imaging." — Charu Venkatesen (epidemiological) [Ep 1 · 0:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=0)
- "Fetal ventriculomegaly is measured at the atrium of the lateral ventricles, with anything larger than 10 millimeters considered abnormal: 10-12mm is mild, 12.1-15mm is moderate, and over 15mm is severe." — Charu Venkatesen (clinical) [Ep 1 · 0:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=0)
- "By the time patients with congenital aqueductal stenosis come to a fetal care center, their ventricular measurements are typically in the moderate or severe range." — Charu Venkatesen (clinical) [Ep 1 · 0:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=0)
- "Congenital aqueductal stenosis on MRI is defined by a thin corpus callosum, thickened tectum, fluid through the aqueduct not seen all the way through with narrowing and obstruction at the inferior portion of the aqueduct, and a large third ventricular recess." — Charu Venkatesen (clinical) [Ep 1 · 0:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=0)
- "The incidence of congenital aqueductal stenosis ranges from 0.5 to 1 per 1000 births." — Charu Venkatesen (epidemiological) [Ep 1 · 3:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=180)
- "Congenital aqueductal stenosis etiology can be acquired (intrinsic obstruction from post-hemorrhagic insult or infection causing gliosis, or extrinsic compression from a mass) or due to genetic disorders including L1CAM mutation, rhombencephalosynapsis, and distroglycanopathies such as Walker-Warburg syndrome." — Charu Venkatesen (clinical) [Ep 1 · 3:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=180)
- "In the literature, postnatal mortality for congenital aqueductal stenosis is reported to range from 34 to 68%." — Charu Venkatesen (host_summary) [Ep 1 · 3:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=180)
- "In the literature, typical development in congenital aqueductal stenosis is reported to range from 4% to 63%." — Charu Venkatesen (host_summary) [Ep 1 · 3:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=180)
- "Epilepsy risk in congenital aqueductal stenosis is reported around 50% in the literature." — Charu Venkatesen (host_summary) [Ep 1 · 3:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=180)
- "In the Cincinnati study of 140 cases of congenital aqueductal stenosis identified by fetal MRI, 16% had early demise (termination or fetal demise), 3% were lost to follow-up, and 113 were live births." — Charu Venkatesen (epidemiological) [Ep 1 · 6:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=360)
- "Of 113 live births in the Cincinnati CAS study, 11% died prior to hospital discharge and 8% were lost to follow-up, leaving short-term neurodevelopmental data available for 86 patients." — Charu Venkatesen (epidemiological) [Ep 1 · 6:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=360)
- "Isolated congenital aqueductal stenosis is defined as CAS being the only anomaly on imaging with no other intra or extracranial findings, while complex CAS includes any accompanying intra or extracranial anomalies or genetic abnormalities." — Charu Venkatesen (clinical) [Ep 1 · 6:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=360)
- "At time of discharge in the Cincinnati study, 95% of complex CAS cases required CSF diversion (all via ventriculoperitoneal shunt) versus 70% of isolated CAS cases." — Charu Venkatesen (clinical) [Ep 1 · 6:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=360)
- "At discharge, 63% of complex CAS cases required feeding support versus 29% of isolated CAS cases." — Charu Venkatesen (clinical) [Ep 1 · 6:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=360)
- "There were no differences between isolated and complex CAS groups in terms of seizures or respiratory support at discharge." — Charu Venkatesen (clinical) [Ep 1 · 6:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=360)
- "For long-term motor outcomes, 93% of isolated CAS patients were fully ambulatory versus 44% of complex CAS patients." — Charu Venkatesen (clinical) [Ep 1 · 6:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=360)
- "None of the isolated CAS patients were non-ambulatory long-term, whereas 32% of complex CAS patients were non-ambulatory." — Charu Venkatesen (clinical) [Ep 1 · 6:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=360)
- "Long-term epilepsy rates were 56% in complex CAS versus 20% in isolated CAS." — Charu Venkatesen (clinical) [Ep 1 · 6:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=360)
- "Long-term feeding support via gastrostomy tube was required in approximately five times as many complex CAS cases compared to isolated CAS cases." — Charu Venkatesen (clinical) [Ep 1 · 6:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=360)
- "If you have isolated CAS, you have very favorable motor outcome." — Charu Venkatesen (opinion) [Ep 1 · 6:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=360)
- "International registries are needed for congenital aqueductal stenosis and other rare prenatally identified neurological conditions to accumulate hundreds to thousands of patients." — Charu Venkatesen (opinion) [Ep 1 · 9:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=540)
- "Many prenatally identified neurological conditions including agenesis of the corpus callosum and vermian hypoplasia can be categorized as isolated or complex, but complex is a very heterogeneous category requiring better genotype-phenotype characterization." — Charu Venkatesen (opinion) [Ep 1 · 9:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=540)
- "Longitudinal studies are needed to characterize the adult-lived experience beyond age 10, including patient and family-defined outcomes such as stressors on families, perception of pain, quality of life, and independence." — Charu Venkatesen (opinion) [Ep 1 · 9:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=540)
- "More studies are needed examining postnatal and fetal interventions to improve outcome in congenital aqueductal stenosis." — Charu Venkatesen (opinion) [Ep 1 · 9:00](https://library.globalcastmd.com/watch/2024-fetal-care-center-frontiers-in-fetal-neurology-day-1-dr-charu-venkatesen-9232?t=540)

## Changelog
- Sep 25: 4 items added automatically

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