Abstract
Bobble-head doll syndrome (BHDS) is a complex syndrome with the dominant symptom of repetitive anteroposterior head movement. Only 57 patients are quoted in the literature. The etiology of this syndrome remains unknown and no standard treatment has yet been established. We hereby report four cases treated at our department. All the patients presented a psychomotor retardation due to an obstructive hydrocephalus. All the patients were treated using neuroendoscopic techniques: two with ventriculocystostomy, and two with ventriculocystocisternostomy. Cyst decompression was achieved in all four cases and clinical recovery was evident in three of the four patients observed. After surgery, BHDS persisted longer the more the subsequent treatment was delayed. In this article, we provide a concise overview of the theories of pathogenesis, presentation, and management of this syndrome. Based on our own experience, we state that the method of choice should be the neuroendoscopy and this must be performed promptly after diagnosis is made.
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This project is supported by the European Regional Development Fund-Project FNUSA-ICRC (No.CZ.1.05/1.1.00/02.0123).
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A portion of this work was presented in the abstract form in June (19th to 24th), 2005, during the XIII International Congress of Neurosurgery, Marrakech.
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In this recording, we can clearly visualize an arachnoid membrane valve formed around the basilar artery that opens and closes simultaneously with the arterial pulsations. Due to the anticipated one-way direction of the valve flow, the cyst is filled with CSF, which cannot run out from it. This leads to the cyst enlargement.
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Guerreiro, H., Vlasak, A., Horinek, D. et al. Bobble-head doll syndrome: therapeutic outcome and long-term follow-up in four children. Acta Neurochir 154, 2043–2049 (2012). https://doi.org/10.1007/s00701-012-1458-2
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DOI: https://doi.org/10.1007/s00701-012-1458-2