Nonsurgical treatment of obstructive hydrocephalus by face-down positioning: Report of four cases

Abstract

Background: Transient obstructive hydrocephalus is a rare condition. Previous case reports have described spontaneous resolution of obstructive hydrocephalus, although the entire mechanism has not yet been clarified. Case description: We report four cases of transient obstructive hydrocephalus after subarachnoid hemorrhage (2 cases) and intra-cerebral hemorrhage (2 cases) caused by obstruction of the aqueduct in patients who presented with altered consciousness that resolved soon after changing their posture from the supine to semi-prone (face-down) position. Conclusions: Face-down positioning might be beneficial for patients with delayed obstructive hydrocephalus, especially that due to a mobile hematoma in the third ventricle. Keywords: Acute hydrocephalus, Transient hydrocephalus, Cerebral aqueduct, Semi-prone position