Pre- and Postoperative MR Imaging of Craniopharyngiomas

1996 ◽  
Vol 37 (3P2) ◽  
pp. 806-812 ◽  
Author(s):  
J. K. Hald ◽  
O. P. Eldevik ◽  
D. J. Quint ◽  
W. F. Chandler ◽  
T. Kollevold
Keyword(s):  
Mr Imaging ◽  
Pituitary Gland ◽  
Third Ventricle ◽  
Optic Chiasm ◽  
Tumour Volume ◽  
Volume Reduction ◽  
Pituitary Stalk ◽  
Residual Tumour ◽  
Mr Images ◽  
The Third

Purpose: To compare the pre- and postoperative MR appearance of craniopharyngiomas with respect to lesion size, tumour morphology and identification of surrounding normal structures. Material and Methods: MR images obtained prior to and following craniopharyngioma resection were evaluated retrospectively in 10 patients. Tumour signal characteristics, size and extension with particular reference to the optic chiasm, the pituitary gland, the pituitary stalk and the third ventricle were evaluated. Results: Following surgery, tumour volume was reduced in all patients. In 6 patients there was further tumour volume reduction between the first and second postoperative images. Two of these patients received radiation therapy between the 2 postoperative studies, while 4 had no adjuvant treatment to the surgical intervention. There was improved visualization of the optic chiasm in 3, the pituitary stalk in one, and the third ventricle in 9 of the 10 patients. The pituitary gland was identified preoperatively only in one patient, postoperatively only in another, pre- and postoperatively in 5, and neither pre- nor postoperatively in 3 patients. In 3 patients MR imaging 0–7 days postoperatively identified tumour remnants not seen at the end of the surgical procedure. The signal intensities of solid and cystic tumour components were stable from pre- to the first postoperative MR images. Optic tract increased signal prior to surgery was gone 28 days postoperatively in one patient, but persisted on the left side for 197 days after surgery in another. Conclusion: Postoperative MR imaging of craniopharyngiomas demonstrated tumour volume reduction and tumour remnants not seen at surgery. Early postoperative MR imaging of craniopharyngiomas may overestimate the size of residual tumour. Improved visualization of peritumoral structures may be achieved.

scholarly journals Extended Endoscopic Endonasal Resection of a Suprasellar and Third Ventricular Retrochiasmatic Craniopharyngioma with a Narrow Pituitary Gland–Optic Chiasm Interval: Techniques to Optimize Resection

2018 ◽  
Vol 79 (S 03) ◽  
pp. S252-S253
Author(s):  
Tyler Kenning ◽  
Carlos Pinheiro-Neto
Keyword(s):  
Pituitary Gland ◽  
Third Ventricle ◽  
Mass Effect ◽  
Optic Chiasm ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Posterior Aspect ◽  
Endoscopic Endonasal ◽  
The Third ◽  
Extended Endoscopic Approach

AbstractThe extended endoscopic endonasal approach can be utilized to surgically treat pathology within the suprasellar space. This relies on a sufficient corridor and interval between the superior aspect of the pituitary gland and the optic chiasm. Tumors located in the retrochiasmatic space and within the third ventricle, however, may not have a widened interval through which to work. With mass effect on the superior and posterior aspect of the optic chiasm, the corridor between the chiasm and the pituitary gland might even be further narrowed. This may negate the possibility of utilizing the endoscopic endonasal approach for the management of pathology in this location. We present a case of a retrochiasmatic craniopharyngioma with a narrow resection corridor that was treated with the extended endoscopic approach and we review techniques to potentially overcome this limitation.The link to the video can be found at: https://youtu.be/ogRZj-aBqeQ.

Intraventricular craniopharyngioma Report of two cases

1971 ◽  
Vol 34 (1) ◽  
pp. 84-87 ◽  
Author(s):  
Ernest L. Cashion ◽  
Joseph M. Young
Keyword(s):  
Pituitary Gland ◽  
Third Ventricle ◽  
Pituitary Stalk ◽  
Content Type ◽  
The Third ◽  
Fine Print

✓ Craniopharyngiomas are usually considered to arise along the pituitary stalk and upper aspect of the pituitary gland. Two cases of craniopharyngioma confined to the third ventricle are reported.

General concepts of hypothalamus-pituitary anatomy

2011 ◽  
pp. 71-81
Author(s):  
Ignacio Bernabeu ◽  
Monica Marazuela ◽  
Felipe F. Casanueva
Keyword(s):  
Median Eminence ◽  
Third Ventricle ◽  
Optic Chiasm ◽  
Perivascular Space ◽  
Ependymal Cells ◽  
The Third ◽  
Long Time ◽  
Central Grey Matter ◽  
Imaginary Line ◽  
The Brain

The hypothalamus is the part of the diencephalon associated with visceral, autonomic, endocrine, affective, and emotional behaviour. It lies in the walls of the third ventricle, separated from the thalamus by the hypothalamic sulcus. The rostral boundary of the hypothalamus is roughly defined as a line through the optic chiasm, lamina terminalis, and anterior commissure, and an imaginary line extending from the posterior commissure to the caudal limit of the mamillary body represents the caudal boundary. Externally, the hypothalamus is bounded rostrally by the optic chiasm, laterally by the optic tract, and posteriorly by the mamillary bodies. Dorsolaterally, the hypothalamus extends to the medial edge of the internal capsule (Fig. 2.1.1) (1). The complicated anatomy of this area of the central nervous system (CNS) is the reason why, for a long time, little was known about its anatomical organization and functional significance. Even though the anatomy of the hypothalamus is well established it does not form a well-circumscribed region. On the contrary, it is continuous with the surrounding parts of the CNS: rostrally, with the septal area of the telencephalon and anterior perforating substance; anterolaterally with the substantia innominata; and caudally with the central grey matter and the tegmentum of the mesencephalon. The ventral portion of the hypothalamus and the third ventricular recess form the infundibulum, which represents the most proximal part of the neurohypophysis. A bulging region posterior to the infundibulum is the tuber cinereum, and the zone that forms the floor of the third ventricle is called the median eminence. The median eminence represents the final point of convergence of pathways from the CNS on the peripheral endocrine system and it is supplied by primary capillaries of the hypophyseal portal vessels. The median eminence is the anatomical interface between the brain and the anterior pituitary. Ependymal cells lining the floor of the third ventricle have processes that traverse the width of the median eminence and terminate near the portal perivascular space; these cells, called tanycytes, provide a structural and functional link between the cerebrospinal fluid (CSF) and the perivascular space of the pituitary portal vessels. The conspicuous landmarks of the ventral surface of the brain can be used to divide the hypothalamus into three parts: anterior (preoptic and supraoptic regions), middle (tuberal region), and caudal (mamillary region). Each half of the hypothalamus is also divided into a medial and lateral zone. The medial zone contains the so-called cell-rich areas with well-defined nuclei. The scattered cells of the lateral hypothalamic area have long overlapping dendrites, similar to the cells of the reticular formation. Some of these neurons send axons directly to the cerebral cortex and others project down into the brainstem and spinal cord.

scholarly journals Combined interhemispheric translamina terminalis and pterional approach for a dorsum sellae meningioma

2017 ◽  
Vol 43 (videosuppl2) ◽  
pp. V4
Author(s):  
Shinya Suematsu ◽  
Hideaki Ono ◽  
Tomohiro Inoue ◽  
Akira Tamura
Keyword(s):  
Surgical Technique ◽  
Third Ventricle ◽  
Pituitary Stalk ◽  
Maximum Diameter ◽  
Pterional Approach ◽  
The Third ◽  
Link Type ◽  
The Right

This video demonstrates a surgical technique of resecting dorsum sellae meningioma using a combined interhemispheric translamina terminalis approach and pterional approach with clinoidectomy. The tumor, 5 cm in maximum diameter, originated from the dorsum sellae, compressed the third ventricle and the midbrain, and displaced the pituitary stalk ventrally. Feeding arteries of the tumor were bilateral meningohypophyseal trunks, mainly from the right side. The authors performed devascularization of the tumor via a right pterional approach following frontotemporal craniotomy, and debulking of the tumor via an interhemispheric translamina terminalis approach following bifrontal craniotomy. These procedures with two separate craniotomies enabled safe and effective resection of the tumor.The video can be found here: https://youtu.be/DEnKOC5zQ_M.

Topographic variations of the optic chiasm and the pituitary stalk: a morphometric study based on midsagittal T2-weighted MR images

2014 ◽  
Vol 36 (8) ◽  
pp. 775-781 ◽  
Author(s):  
Hao Long ◽  
Song-tao Qi ◽  
Ye Song ◽  
Jun Pan ◽  
Xi-an Zhang ◽  
...  
Keyword(s):  
Optic Chiasm ◽  
Pituitary Stalk ◽  
Morphometric Study ◽  
Mr Images

scholarly journals The secretion of inorganic phosphate by the kidney.—II. Influence of the pituitary gland and of the wall of the third ventricle

1925 ◽  
Vol 99 (694) ◽  
pp. 70-91 ◽  
Keyword(s):  
Pituitary Gland ◽  
Inorganic Phosphate ◽  
Third Ventricle ◽  
Inorganic Phosphorus ◽  
Inorganic Salts ◽  
Potassium Ions ◽  
Separate Study ◽  
The Third ◽  
Phosphate Excretion

In previous experiments on the diuretic properties of calcium and potassium ions (1), we tried the effect of removing various organs from the whole animal, in order to investigate whether they exert some influence on the secretory functions of the kidney. We were struck by the fact that after removal of the pituitary body, the kidney may lose in the following few hours its power of secreting inorganic phosphorus. Since in those experiments inorganic salts, which may have an influence on P secretion, were injected, we started a separate study of the action of the pituitary on phosphate excretion.

scholarly journals Mature Teratoma in the Third Ventricle: A Case Report and Review of the Literature

2021 ◽  
pp. 1-4
Author(s):  
Yanire Sánchez Medina ◽  
Yanire Sánchez Medina ◽  
Eric Robles Hidalgo ◽  
Jaime Domínguez Baez ◽  
Luis Gómez Perals
Keyword(s):  
Case Report ◽  
Germ Cell ◽  
Third Ventricle ◽  
Mature Teratoma ◽  
Germ Cell Tumors ◽  
Optic Chiasm ◽  
Pineal Region ◽  
The Third ◽  
Histopathologic Evaluation ◽  
Cell Layers

Introduction: Germ Cell Tumors (GCT) represent less than 4% of primary brain tumors. They comprise Germaniums, Non-Germinomatous Germ Cell Tumors and Teratomas. Teratomas represent less than 20% of intracranial GCT. They are tumors of multipotential cells derived from all 3 germ cell layers, frequently arising in midline structures, most commonly in the pineal and suprasellar regions, with a clear excess of male cases and frequently found in children and young adults. We report a case of a mature teratoma in the third ventricle in a 37-year-old male. Case Report: We report a case of a 37-year-old male with a history of headache lasting up to 9 days and refractory to pharmacological treatment. The CT scan revealed a 20mm round hypodense lesion in the anterior third ventricle, with a punctate hyperdensity in the inferior pole causing biventricular hydrocephalus with no periventricular lucency and the MRI showed a well-defined encapsulated mass lesion attached to the roof of the third ventricle, isointense in T1WI with circumferential enhancement and hyperintense in T2WI. Gross total resection was performed. Histopathologic evaluation revealed a mature teratoma. There was no evidence of recurrence on follow up MRI at 2 years. Conclusion: Intracranial teratomas typically originate in midline structures from optic chiasm to pineal region. Presentation after the first two decades of life is exceptional. Complete surgical resection is the only curative treatment for pure mature teratomas. We report the case of a mature teratoma in a 37-year-old male with unusual radiological findings.

Expanded endonasal approach, a fully endoscopic transnasal approach for the resection of midline suprasellar craniopharyngiomas: a new classification based on the infundibulum

2008 ◽  
Vol 108 (4) ◽  
pp. 715-728 ◽  
Author(s):  
Amin B. Kassam ◽  
Paul A. Gardner ◽  
Carl H. Snyderman ◽  
Ricardo L. Carrau ◽  
Arlan H. Mintz ◽  
...  
Keyword(s):  
Classification Scheme ◽  
Third Ventricle ◽  
Optic Chiasm ◽  
Tumor Classification ◽  
Type I ◽  
Endonasal Approach ◽  
Transnasal Approach ◽  
Endoscopic Endonasal ◽  
The Third ◽  
Expanded Endonasal Approach

Object Craniopharyngiomas are notoriously difficult to treat. Surgeons must weigh the risks of aggressive resection against the long-term challenges of recurrence. Because of their parasellar location, often extending well beyond the sella, these tumors challenge vision and pituitary and hypothalamic function. New techniques are needed to improve outcomes in patients with these tumors while decreasing treatment morbidity. An endoscopic expanded endonasal approach (EEA) is one such technique that warrants understanding and evaluation. The authors explain the techniques and approach used for the endoscopic endonasal resection of suprasellar craniopharyngiomas and introduce a tumor classification scheme. Methods The techniques and approach used for the endoscopic, endonasal resection of suprasellar craniopharyngiomas is explained, including the introduction of a tumor classification scheme. This scheme is helpful for understanding both the appropriate expanded approach as well as relevant involved anatomy. Results The classification scheme divides tumors according to their suprasellar extension: Type I is preinfundibular; Type II is transinfundibular (extending into the stalk); Type III is retroinfundibular, extending behind the gland and stalk, and has 2 subdivisions (IIIa, extending into the third ventricle; and IIIb, extending into the interpeduncular cistern); and Type IV is isolated to the third ventricle and/or optic recess and is not accessible via an endonasal approach. Conclusions The endoscopic EEA requires a thorough understanding of both sinus and skull base anatomy. Moreover, in its application for craniopharyngiomas, an understanding of tumor growth and extension with respect to the optic chiasm and infundibulum is critical to safely approach the lesion via an endonasal route.

scholarly journals Central Diabetes Insipidus as the Inaugural Manifestation of Langerhans Cell Histiocytosis: Natural History and Medical Evaluation of 26 Children and Adolescents

2011 ◽  
Vol 96 (9) ◽  
pp. E1352-E1360 ◽  
Author(s):  
Isis Marchand ◽  
Mohamed Aziz Barkaoui ◽  
Catherine Garel ◽  
Michel Polak ◽  
Jean Donadieu ◽  
...  
Keyword(s):  
Diabetes Insipidus ◽  
Langerhans Cell Histiocytosis ◽  
Third Ventricle ◽  
Langerhans Cell ◽  
Central Diabetes Insipidus ◽  
Pituitary Stalk ◽  
The Third ◽  
Mri Features ◽  
Pituitary Stalk Thickening

Abstract Context: Isolated central diabetes insipidus (CDI) can be the first manifestation of Langerhans cell histiocytosis (LCH), creating diagnostic dilemmas such as dysgerminoma and other inflammatory lesions. Method: In 2010, the French national LCH registry had enrolled 1236 LCH patients under 18 yr of age. Isolated CDI was the initial presentation of LCH in 26 patients. We reviewed their clinical and magnetic resonance imaging (MRI) features. Results: Median age at the diagnosis of CDI was 9.6 yr (1.8–16.3), and median follow-up after CDI diagnosis was 9.9 yr (3.5–26.6). In addition to CDI, two patients had visual field defects, four had secondary amenorrhea, and 11 had anterior pituitary deficiency. Cerebral imaging (including computed tomography in two cases), performed in 22 patients within 3 months of CDI diagnosis, showed pituitary stalk thickening in 14 patients, which was moderate (3.0–7 mm) in nine cases and marked (>7 mm) in five cases. In eight cases, the lesion extended to the floor of the third ventricle. One child with LCH presented with a mild enlarged sellar content. During follow-up, 22 patients developed extrapituitary involvement, mainly of bone (n = 15), lung (n = 9), and skin (n = 9). Pituitary biopsy was performed in eight cases and was conclusive in six cases. Conclusions: Pituitary stalk thickening can be observed in LCH as well as lesions extending to the floor of the third ventricle. In all cases but one, the intrasellar content was not enlarged. Long-term follow-up with close attention to bone, skin, and lung disorders may lead to the diagnosis of LCH.

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