Trapped Fourth Ventricle in an Adult: Radiographic findings and surgical treatment

1990 ◽  
pp. 108-109
Author(s):  
Jerry L. Hubbard ◽  
O. Wayne Houser ◽  
Edward R. Laws
Keyword(s):  
Surgical Treatment ◽  
Fourth Ventricle ◽  
Radiographic Findings ◽  
Trapped Fourth Ventricle

Trapped fourth ventricle in an adult: radiographic findings and surgical treatment

1987 ◽  
Vol 28 (4) ◽  
pp. 301-306 ◽  
Author(s):  
Jerry L. Hubbard ◽  
O. Wayne Houser ◽  
Edward R. Laws
Keyword(s):  
Surgical Treatment ◽  
Fourth Ventricle ◽  
Radiographic Findings ◽  
Trapped Fourth Ventricle

The marionette technique for treatment of isolated fourth ventricle

2013 ◽  
Vol 12 (4) ◽  
pp. 339-343 ◽  
Author(s):  
Pierluigi Longatti ◽  
Elisabetta Marton ◽  
Salima Magrini
Keyword(s):  
Surgical Treatment ◽  
Fourth Ventricle ◽  
Third Ventricle ◽  
Operating Rooms ◽  
Simple Method ◽  
Less Invasive ◽  
Isolated Fourth Ventricle ◽  
Ventricular Catheters ◽  
Endoscopic Aqueductoplasty

Isolated fourth ventricle is not uncommon in complex posthemorrhagic or postinfectious hydrocephalus. When the condition is symptomatic, the current surgical treatment is endoscopic aqueductoplasty, followed by endoscope-assisted placement of a catheter in the fourth ventricle. The authors suggest a very simple method of steering the tip of standard ventricular catheters by using materials commonly available in all operating rooms. The main advantage of this method is that it permits less invasive transaqueductal drainage of trapped fourth ventricles, especially in cases of narrow third ventricle, because the scope and catheter are introduced in sequence and not in a double-barreled fashion. Two illustrative cases are reported.

Posterior fossa craniotomy for trapped fourth ventricle in shunt-treated hydrocephalic children: long-term outcome

2011 ◽  
Vol 7 (1) ◽  
pp. 52-63 ◽  
Author(s):  
Suhas Udayakumaran ◽  
Naresh Biyani ◽  
David P. Rosenbaum ◽  
Liat Ben-Sira ◽  
Shlomi Constantini ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Subarachnoid Space ◽  
Fourth Ventricle ◽  
Late Complication ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Posthemorrhagic Hydrocephalus ◽  
Spinal Subarachnoid Space ◽  
Trapped Fourth Ventricle

Object Trapped fourth ventricle (TFV) is a rare late complication of postinfectious or posthemorrhagic hydrocephalus. This entity is distinct from a large fourth ventricle because TFV entails pressure in the fourth ventricle and posterior fossa due to abnormal inflow and outflow of CSF, causing significant symptoms and signs. As TFV is mostly found in children who were born prematurely and have cerebral palsy, diagnosis and treatment options are a true challenge. Methods Between February 1998 and February 2007, 12 children were treated for TFV in Dana Children's Hospital by posterior fossa craniotomy/craniectomy and opening of the TFV into the spinal subarachnoid space. The authors performed a retrospective analysis of relevant data, including pre- and postoperative clinical characteristics, surgical management, and outcome. Results Thirteen fenestrations of trapped fourth ventricles (FTFVs) were performed in 12 patients. In 6 patients with prominent arachnoid thickening, a stent was left from the opened fourth ventricle into the spinal subarachnoid space. One patient underwent a second FTFV 21 months after the initial procedure. No perioperative complications were encountered. All 12 patients (100%) showed clinical improvement after FTFV. Radiological improvement was seen in only 9 (75%) of the 12 cases. The follow-up period ranged from 2 to 9.5 years (mean 6.11 ± 2.3 years) after FTFV. Conclusions Fenestration of a TFV via craniotomy is a safe and effective option with a very good long-term outcome and low rate of morbidity.

Parosteal Osteogenic Sarcoma of the Mastoid Bone

1997 ◽  
Vol 106 (9) ◽  
pp. 729-732 ◽  
Author(s):  
Daniel R. Seely ◽  
George A. Gates
Keyword(s):  
Surgical Treatment ◽  
Osteogenic Sarcoma ◽  
Signs And Symptoms ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Long Bones ◽  
En Bloc ◽  
Radiographic Findings ◽  
Surrounding Soft Tissue ◽  
Mastoid Bone

Parosteal osteogenic sarcoma (POS) is an uncommon surface bone tumor, most often arising from the metaphyseal end of long bones. Involvement of the cranial bones is rare, with only 1 case of mastoid bone POS previously reported in the literature. Two patients with POS of the mastoid are presented, 1 followed up for 25 years after surgical treatment. The presenting signs and symptoms, as well as distinctive radiographic findings, are discussed. Histologic features are also described. Typically, cranial POS appears as a sessile, densely ossified surface growth with radiating bone spicules that blend with surrounding soft tissue. Treatment is en bloc resection, which is curative in most cases.

Diagnosis and Management of Borderline Hip Dysplasia and Acetabular Retroversion

2018 ◽  
Vol 02 (04) ◽  
pp. 156-166
Author(s):  
Tai Holland ◽  
Holly Thomas-Aitken ◽  
Jessica Goetz ◽  
Michael Willey
Keyword(s):  
Surgical Treatment ◽  
Hip Dysplasia ◽  
Groin Pain ◽  
Periacetabular Osteotomy ◽  
Hip Pain ◽  
Acetabular Retroversion ◽  
Short Term ◽  
Radiographic Findings ◽  
Lateral Hip Pain

AbstractBorderline hip dysplasia and acetabular retroversion are common radiographic findings in young individuals with and without hip pain. Orthopaedic surgeons should be knowledgeable about the radiographic findings, diagnosis, and appropriate nonsurgical and surgical treatment of these conditions. Borderline hip dysplasia is generally defined by a lateral center edge angle of Wiberg from 20 to 25° (some define as 18–25°) and is a cause of joint microinstability. The degree of soft tissue laxity can have significant implications for joint stability in patients with borderline hip dysplasia. The most common presenting symptoms are groin pain and lateral hip pain. Acetabular retroversion is defined by radiographic findings of crossover sign, ischial spine sign, and posterior wall sign. Individuals with symptomatic retroversion have a clinical presentation consistent with impingement, groin pain with flexion activities, and less commonly lateral hip pain. Physical therapy has been shown to improve symptoms in a subset of individuals with these conditions. There are multiple recent publications about arthroscopic treatment of patients with borderline hip dysplasia. These reports generally find that good short-term outcomes can be expected when using arthroscopic techniques that include labral preservation/repair and capsular plication. There are limited reports of periacetabular osteotomy as a treatment for borderline hip dysplasia. Publications focusing specifically on surgical treatment of acetabular retroversion are also infrequent. Periacetabular osteotomy has been shown to have superior long-term clinical outcomes to surgical hip dislocation with anterior rim trimming in patients with all three radiographic findings of retroversion. Arthroscopic treatment has been shown to have good short-term outcomes. Future work in the areas of borderline hip dysplasia and acetabular retroversion should focus on reporting long-term clinical follow-up of these surgical treatments and using computation techniques as a tool to determine appropriate surgical and nonsurgical treatment for each individual patient.

Syringobulbia in a Pediatric Population

Neurosurgery ◽  
2005 ◽  
Vol 57 (6) ◽  
pp. 1147-1153 ◽  
Author(s):  
Jeremy D.W. Greenlee ◽  
Arnold H. Menezes ◽  
Bryan A. Bertoglio ◽  
Kathleen A. Donovan
Keyword(s):  
Posterior Fossa ◽  
Cranial Nerve ◽  
Fourth Ventricle ◽  
Pediatric Population ◽  
Demographic Data ◽  
Posterior Fossa Decompression ◽  
Radiographic Findings ◽  
Presenting Symptoms ◽  
Cranial Nerve Dysfunction ◽  
Cranial Nerve Palsies

Abstract OBJECTIVE: To better understand the presentation, management, and outcome of syringobulbia in the pediatric age group. METHODS: The University of Iowa pediatric neurosurgery database was searched for patients under the age of 18 with a diagnosis of syringobulbia. The patients' records were retrospectively reviewed for demographic data, chief complaint and presenting symptoms, neurological and radiographic findings, treatment, outcome, and complications. Children with open neural tube defects and Chiari II malformations were excluded. RESULTS: Six pediatric patients were identified as meeting inclusion criteria. The average age at time of surgery was 14.8 years. The chief complaints were vision impairment in three children and numbness, gait instability, and headache worsened with Valsalva in one patient each. Other prominent symptoms included sleep apnea and weakness. All patients showed at least one cranial nerve dysfunction. Radiographs revealed hindbrain herniation and associated syringomyelia in all cases. Two patients had scoliosis. Treatment was posterior fossa decompression with cerebellar tonsillar shrinkage, opening of foramen of Magendie, and duraplasty. Two patients also required concomitant ventral decompression. The cavity of syringobulbia communicated with syringomyelia and the fourth ventricle in most children but was distinct from the fourth ventricle. Two patients received fourth ventricle to subarachnoid shunts. Follow-up averaged 3.2 years, and all patients clinically improved after surgery. Magnetic resonance imaging documented resolution of syringobulbia in all cases, with syringomyelia improving in all cases. There was no permanent morbidity or mortality in the series. CONCLUSION: Syringobulbia is strongly associated with Chiari malformation and syringomyelia, and patients often present because of cranial nerve palsies. Posterior fossa decompression is a safe and effective treatment.

Surgical treatment of the tumors of the fourth ventricle through telovelar approach

2018 ◽  
Vol 20 (2) ◽  
pp. 8-16 ◽  
Author(s):  
A. V. Kalinovskiy ◽  
S. V. Chernov ◽  
A. V. Zotov ◽  
A. R. Kasymov ◽  
E. V. Gormolysova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Brain Stem ◽  
Fourth Ventricle ◽  
Radical Resection ◽  
Adult Patients ◽  
Study Objective ◽  
Results Of Treatment ◽  
Telovelar Approach ◽  
Ventricular Tumors

The study objectiveis analysis of surgical treatment results of adult patients with tumors of the fourth ventricle and determination of predictors of unsuccessful outcomes.Materials and methods.In the present study we review results of treatment of 33 adult patients with tumors of the fourth ventricle, which were operated via telovelar approach in Federal Neurosurgical Center (Novosibirsk). The most common symptoms included hydrocephalus (54.5 %), cerebellar dysfunction (33.3 %), cranial nerve deficits (30.3 %). The tumor size was more than 40 mm in 22 cases (66.7 %). The brain stem invasion was occurred in 21 cases (63.6 %).Results.23 tumors were removed totally (69.7 %). Hydrocephalus was regressed in 17 cases (94.5 %). Cerebellar mutism did not occur in any patient. Conclusion.Predictors of poor result may be brain stem invasion, non-radical resection of tumor and preoperative hydrocephalus. We suggest, that the preoperative hydrocephalus should not been operated in the most cases of the fourth ventricular tumors.

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