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An adult presented with signs of chronic obstructive hydrocephalus. Angiography showed an arteriovenous malformation in the region of the posterior diencephalon and mesencephalon with venous drainage into the vein of Galen. Pneumoencephalography demonstrated obstruction of the aqueduct. This case affirms the need to consider the presence of an arteriovenous malformation in adults who present with signs of aqueductal stenosis.
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