Successful Removal of Air Gun Bullets from the Third Ventricle

Abstract Eighteen patients with a colloid cyst of the 3rd ventricle presented to the Frenchay Hospital Neurosurgery Unit. The investigations included computed tomography (CT). Of these patients, 9 had radiographically isodense cysts that caused considerable diagnostic difficulties, being described only as an anterior 3rd ventricular space-occupying lesion and lateral ventricular dilatation in all but 2 cases. The clinical findings are described and the CT appearance is discussed. The new use of ventriculoscopy may resolve the problem rapidly; ventriculoscopy made the diagnosis in 5 cases and confirmed a CT diagnosis in 3 others. (It has also confirmed the diagnosis in 2 cases of hyperdense cysts.) Lately, it has been possible to aspirate the cyst contents endoscopically or, if the colloid is too viscous, to remove it with endoscopic rongeurs. After either of these procedures, the cyst wall can be coagulated with diathermy endoscopically. The method is described, and the advantages over other investigations and treatment are discussed.

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DIZYGOTIC TWINS WITH A COLLOID CYST OF THE THIRD VENTRICLE

Neurosurgery ◽

10.1227/01.neu.0000330388.91098.89 ◽

2008 ◽

Vol 63 (5) ◽

pp. E1003-E1003 ◽

Cited By ~ 10

Author(s):

Rossana Romani ◽

Mika Niemelä ◽

Miikka Korja ◽

Juha A. Hernesniemi

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Obstructive Hydrocephalus ◽

Third Ventricle ◽

Colloid Cyst ◽

Resonance Imaging ◽

Transcallosal Approach ◽

The Third ◽

Familial Cases ◽

Colloid Cysts

Abstract OBJECTIVE AND IMPORTANCE Colloid cysts of the third ventricle are rare benign tumors of endodermal origin accounting for 1% of all intracranial tumors. Interestingly, a few familial cases have been reported previously. We present the first case of dizygotic twins with a symptomatic colloid cyst of the third ventricle. CLINICAL PRESENTATION A 10-year-old boy was admitted to a local hospital in 1993 because of severe progressive headache. Computed tomographic and magnetic resonance imaging scans revealed acute obstructive hydrocephalus attributable to a third ventricular colloid cyst, which was removed after emergent ventricular drainage. Fourteen years later, a nonidentical twin brother complained of continuous headache with nausea and vomiting. A magnetic resonance imaging scan showed obstructive hydrocephalus and a third ventricle colloid cyst, which was removed by use of the transcallosal approach. INTERVENTION Both twins underwent complete removal of the cyst by the interhemispheric transcallosal approach without postoperative complications. CONCLUSION On the basis of a literature review, 2 cases of colloid cysts of the third ventricle in monozygotic twins and a few familial cases have been reported. Our case is the first in dizygotic twin brothers. These findings suggest that the prevalence of colloid cyst may be higher in twins than in the general population. We believe that the presence of this lesion in a twin necessitates magnetic resonance imaging of the other twin, and a clinical follow-up would be recommended in all other first-degree relatives.

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Xanthogranulomas of the Third Ventricle

Neurosurgery ◽

10.1227/00006123-197904000-00010 ◽

1979 ◽

Vol 4 (4) ◽

pp. 329-333 ◽

Cited By ~ 22

Author(s):

Jeffery L. Rush ◽

John A. Kusske ◽

Robert W. Porter ◽

Henry W. Pribram

Keyword(s):

Differential Diagnosis ◽

Intracranial Pressure ◽

Computerized Tomography ◽

Third Ventricle ◽

Increased Intracranial Pressure ◽

The Third ◽

Lateral Ventricles ◽

Rare Tumors ◽

3Rd Ventricle

Abstract Two patients with xanthogranuloma of the 3rd ventricle are described. In each instance the tumor obstructed the interventricular foramina and caused dilatation of the lateral ventricles and signs of increased intracranial pressure; computerized tomography demonstrated the dense, nonenhancing lesion in the anterior 3rd ventricle. The pathogenesis of these rare tumors is discussed. These cases affirm the need to consider xanthogranuloma in the differential diagnosis of anterior 3rd ventricle tumors in adults.

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Anterior Interhemispheric Transcallosal Approach for Thalamic Cavernous Malformation: 2-Dimensional Operative Video

Operative Neurosurgery ◽

10.1093/ons/opz260 ◽

2019 ◽

Vol 17 (6) ◽

pp. E240-E241

Author(s):

Benjamin K Hendricks ◽

Robert F Spetzler

Keyword(s):

Cavernous Malformation ◽

Third Ventricle ◽

Video Recording ◽

Complete Resection ◽

Institutional Review Board ◽

Transcallosal Approach ◽

The Third ◽

Institutional Review Board Approval ◽

Institutional Review ◽

Surgical Field

Abstract This patient had a large left ventral thalamic cavernous malformation abutting the third ventricle with evidence of recent hemorrhage. The patient was placed supine with the head in the horizontal position with the dependent hemisphere down to permit use of the anterior interhemispheric transcallosal approach. The lateral ventricle is entered, and the septum pellucidum is opened to prevent it from obstructing the surgical field. The deep cavernous malformation is located with stereotactic neuronavigation and removed piecemeal with the aid of lighted suckers and bipolars. Surgical visualization and postoperative imaging demonstrate a complete resection of the lesion, and the patient remained neurologically stable postoperatively. The patient gave informed consent for surgery and video recording. Institutional review board approval was deemed unnecessary. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.

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Microsurgery of the Third Ventricle: Part 2

Neurosurgery ◽

10.1227/00006123-198103000-00007 ◽

1981 ◽

Vol 8 (3) ◽

pp. 357-373 ◽

Cited By ~ 119

Author(s):

Albert L. Rhoton ◽

Isao Yamamoto ◽

David A. Peace

Keyword(s):

Third Ventricle ◽

Posterior Part ◽

Anterior Portion ◽

Posterior Portion ◽

The Third ◽

3Rd Ventricle

Abstract The operative approaches to the 3rd ventricle are divided on the basis of whether they are suitable for reaching the anterior or posterior part of the 3rd ventricle. The approaches suitable for lesions within or compressing the anterior portion of the 3rd ventricle are the trans-sphenoidal, subfrontal, frontotemporal, subtemporal, anterior transcallosal, and anterior transventricular. The approaches suitable for reaching the posterior portion of the 3rd ventricle are the posterior transcallosal, posterior transventricular, occipital transtentcrial, and infratentorial supracerebellar. Considerations important in selecting one of these approaches are reviewed.

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Malignant Meningioma within the Third Ventricle: A Case Report

Neurosurgery ◽

10.1227/00006123-198703000-00019 ◽

1987 ◽

Vol 20 (3) ◽

pp. 465-468 ◽

Cited By ~ 27

Author(s):

Scott W. Strenger ◽

Yun Peng Huang ◽

Ved P. Sachdev

Keyword(s):

Case Report ◽

Malignant Transformation ◽

Third Ventricle ◽

Ventricular System ◽

Malignant Meningioma ◽

The Third ◽

3Rd Ventricle

Abstract A case of a malignant meningioma within the 3rd ventricle is presented. Although malignant transformation of meningiomas has been described, occurrence within the ventricular system is extremely rare.

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Pilomyxoid astrocytoma in a patient presenting with fatal hemorrhage

Journal of Neurosurgery Pediatrics ◽

10.3171/ped/2008/1/3/244 ◽

2008 ◽

Vol 1 (3) ◽

pp. 244-246 ◽

Cited By ~ 21

Author(s):

Hideo Hamada ◽

Masanori Kurimoto ◽

Nakamasa Hayashi ◽

Shoichi Nagai ◽

Kunikazu Kurosaki ◽

...

Keyword(s):

Intraventricular Hemorrhage ◽

Third Ventricle ◽

External Ventricular Drainage ◽

Resonance Imaging ◽

Imaging Studies ◽

Pilomyxoid Astrocytoma ◽

Transcallosal Approach ◽

The Third ◽

Suprasellar Region ◽

Fatal Hemorrhage

✓The authors report on a rare case of pilomyxoid astrocytoma in a patient presenting with fatal hemorrhage. This 5-year-old boy presented to the outpatient clinic with headache and vomiting. Computed tomography and magnetic resonance imaging studies revealed a mass lesion with partial hemorrhage in the suprasellar region extending into the third ventricle. Partial resection via a transcallosal approach was performed. Because the pathological diagnosis was pilomyxoid astrocytoma, chemotherapy was administered. However, 4 months after the first operation, during chemotherapy, the boy presented with massive intratumoral and intraventricular hemorrhage with hydrocephalus. Although emergent external ventricular drainage was performed, the patient died. In this report, the authors review the literature and discuss the clinical features and treatment of pilomyxoid astrocytoma.

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Surgical approaches to the third ventricle of the brain in children

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care ◽

10.17816/psaic726 ◽

2021 ◽

Vol 11 (1) ◽

pp. 47-54

Author(s):

Sergey K. Gorelyshev ◽

Olga A. Medvedeva

Keyword(s):

Third Ventricle ◽

Pineal Region ◽

Anterior Horn ◽

Surgical Approaches ◽

Surgical Interventions ◽

Transcallosal Approach ◽

Advantages And Disadvantages ◽

The Third ◽

Lateral Ventricles ◽

The Brain

AIM: This study aimed to describe and analyze the advantages and disadvantages of various surgical approaches to neoplasms of the third ventricle of the brain in children. MATERIALS AND METHODS: This study analyzed surgical interventions to the third ventricle in 657 patients, performed at the Academician N.N. Burdenko of the Research Institute of Neurosurgery from 1998 to 2018. These included 375 patients with intra-extraventricular craniopharyngiomas and 282 patients with gliomas of the third ventricle and chiasm. The patients age ranged from 3 mon to 18 years old. RESULTS: The anterior transcallosal approach provides access to the anterior horn and bodies of the lateral ventricles, as well as the third ventricle. The transfornical approach provides more opportunities for access to both the anterior and posterior parts of the third ventricle; however, it has a high risk of trauma to the fornix. The subchoroidal approach provides a very good view of the posterior parts of the third ventricle, especially of the pineal region; however, it has even greater restrictions on viewing its anterior parts. When compared with the transcallosal approach, the transfrontal approach can be used more safely in the absence of hydrocephalus (if the tumor is located in the anterior horn). No specific complications were inherent in a particular approach (seizures were registered in 1%, transient hemiparesis was noted in 10%, and transient memory impairments were revealed in 5% of cases). CONCLUSION: The use of a transcallosal approach is safe even in infants. The transcortical approach is recommended mainly for large tumors of the lateral ventricles, and the transcallosal approach should be used for small tumors of the third ventricle. No specific complications were inherent in a particular approach, and the choice was determined by the assessment of the exact location of the tumor and calculation of the most relevant trajectory for its achievement as well as the aim (biopsy or radical removal). Analysis of magnetic resonance imaging and neuronavigation are significant in the selection of surgical approaches.

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