Late Presentation of Congenital Aqueduct Stenosis in Adulthood with High-Riding Basilar Artery: Case Report

Background A rare variant of congenital aqueductal stenosis (CAS) is known as adult-onset CAS, characterized by the emergence of symptoms during adulthood. Case Description A 35-year-old man presented complaining of acute-onset headache and vomiting. Magnetic resonance imaging of the brain revealed an acute hydrocephalus due to an aqueductal web. The patient was treated with a ventriculoperitoneal shunt and doing well. His condition was complicated by subdural hematoma as a result of overshunting, which was treated by frontoparietal craniotomy and eventually, he underwent valve revision to a programmable valve. Conclusion Additional research is needed to gain a deeper understanding of the hypothesis related to adult aqueductal stenosis. This will help shed light on the asymptomatic childhood phase and potentially reduce complications by identifying late CAS early.