Endoscopic Treatment of a Fourth Ventricle Arachnoid Cyst via the Third Ventricle: A Case Report

2014 ◽  
Vol 10 (2) ◽  
pp. E374-E378 ◽  
Author(s):  
Matteo Martinoni ◽  
Francesco Toni ◽  
Mariella Lefosse ◽  
Eugenio Pozzati ◽  
Anna Federica Marliani ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Arachnoid Cyst ◽  
Fourth Ventricle ◽  
Fluid Dynamic ◽  
Third Ventricle ◽  
Arachnoid Cysts ◽  
Complete Excision ◽  
The Third ◽  
Neurosurgical Treatment ◽  
Cerebrospinal Fluid Dynamic

Abstract BACKGROUND AND IMPORTANCE: Arachnoid cysts within the fourth ventricle have rarely been reported in the literature. Different procedures have been performed to restore a normal cerebrospinal fluid dynamic or pressure, including shunting and partial or complete excision of the cyst by open microsurgery. Cerebrospinal fluid shunts give only partial improvement of symptoms and are prone to malfunctions. The microsurgical excision of the cyst seems to offer the best chance of success. CLINICAL PRESENTATION: We report the case of a fourth ventricle arachnoid cyst successfully treated with a complete endoscopic cerebral procedure via the third ventricle. CONCLUSION: Endoscopic fenestration of fourth ventricle arachnoid cysts may be considered an effective neurosurgical treatment.

Migrating Lateral Ventricle Choroid Plexus Cyst into the Fourth Ventricle Causing Acute Hydrocephalus

2021 ◽  
Author(s):  
Lacey M. Carter ◽  
Benjamin Cornwell ◽  
Naina L. Gross
Keyword(s):  
Cerebrospinal Fluid ◽  
Choroid Plexus ◽  
Lateral Ventricle ◽  
Fourth Ventricle ◽  
Third Ventricle ◽  
Neurological Deficits ◽  
Cerebral Aqueduct ◽  
Outflow Obstruction ◽  
The Third ◽  
Choroid Plexus Cyst

AbstractChoroid plexus cysts consist of abnormal folds of the choroid plexus that typically resolve prior to birth. Rarely, these cysts persist and may cause outflow obstruction of cerebrospinal fluid. We present a 5-month-old male born term who presented with lethargy, vomiting, and a bulging anterior fontanelle. Magnetic resonance imaging showed one large choroid plexus cyst had migrated from the right lateral ventricle through the third ventricle and cerebral aqueduct into the fourth ventricle causing outflow obstruction. The cyst was attached to the lateral ventricle choroid plexus by a pedicle. The cyst was endoscopically retrieved from the fourth ventricle intact and then fenestrated and coagulated along with several other smaller cysts. Histologic examination confirmed the mass was a choroid plexus cyst. The patient did well after surgery and did not require any cerebrospinal fluid diversion. Nine months after surgery, the patient continued to thrive with no neurological deficits. This case is the first we have found in the literature of a lateral ventricular choroid plexus cyst migrating into the fourth ventricle and the youngest of any migrating choroid plexus cyst. Only three other cases of a migrating choroid plexus cyst have been documented and those only migrated into the third ventricle. New imaging advances are making these cysts easier to identify, but may still be missed on routine sequences. High clinical suspicion for these cysts is necessary for correct treatment of this possible cause of hydrocephalus.

scholarly journals Gender differences in the structure of the cerebrospinal fluid system of pre-school children

2021 ◽  
pp. 13-17
Author(s):  
S. E. Baibakov ◽  
N. S. Bakhareva ◽  
E. K. Gordeeva ◽  
M. V. Yuzhakov ◽  
D. A. Khromov ◽  
...  
Keyword(s):  
Gender Differences ◽  
Cerebrospinal Fluid ◽  
School Children ◽  
Fourth Ventricle ◽  
Third Ventricle ◽  
Posterior Horn ◽  
Anterior Horn ◽  
Fluid System ◽  
The Third ◽  
The Brain

Relevance Investigation of the cerebrospinal fluid system of children of different ages, especially pre-school and school periods of childhood, becomes essential, since the further development of the brain and its proper functioning depends on the way it functions. Considering the MRI indications of the elements of the cerebrospinal fluid system of children is important for the development of neurology and neurosurgery, it is necessary to consider gender differences in the brain size and structure.Objective To study the sex differences in the structure of the cerebrospinal fluid system in seven-year-old children.Material and Methods For the study, archival data on the sizes of the lateral ventricles of the brain of 120 children aged 7 (60 boys and 60 girls) were involved, in particular: 1) the length of the anterior horn; 2) the width of the anterior horn; 3) the length of the central part; 4) the width of the central part; 5) the length of the posterior horn; 6) the width of the posterior horn; 7) the length of the lower horn; 8) the anteroposterior size; 9) the distance between the anterior horns; 10) the distance between the posterior horns; 11) the length of the third ventricle; 12) the height of the third ventricle; 13) the length of the aqueduct; 14) the length of the fourth ventricle; 15) the height of the fourth ventricle. The studies were carried out using the method of magnetic resonance imaging. Quantitative indicators were assessed for compliance with the normal distribution using the KolmogorovSmirnov test. The accumulation, correction, systematization of the initial information were carried out in Microsoft Excel 2016. Statistical analysis was carried out using the Statistica 10.0 software (StatSoft Inc., USA). The results were considered statistically significant at p < 0.05.Results The data obtained in the study of the cerebrospinal fluid system in children during their pre-school period of childhood are indicators of the norm and can be used for diagnostic studies in the departments of radiation diagnostics. The bilateral asymmetry of the lateral ventricles of the brain in pre-school children, discovered during the work, is of crucial clinical significance. The morphometric indicators of the elements of the cerebrospinal fluid system should be considered by specialists in the study of brain neuroplasticity.Conclusion Analysis of the obtained in vivo encephalometric data indicates the presence of sexual variability of the brain and parameters of the structures of the cerebrospinal fluid.

THE INFLUENCE OF THE CONCENTRATION OF SODIUM AND POTASSIUM IN THE CEREBROSPINAL FLUID ON THE SECRETION OF STEROIDS, INCLUDING ALDOSTERONE, FROM THE ADRENAL CORTEX

1961 ◽  
Vol 37 (4) ◽  
pp. 559-564 ◽  
Author(s):  
Nils Norman
Keyword(s):  
Cerebrospinal Fluid ◽  
Fourth Ventricle ◽  
Third Ventricle ◽  
The Other ◽  
Potassium Content ◽  
Fluid Mixtures ◽  
The Third ◽  
Artificial Cerebrospinal Fluid ◽  
The Right ◽  
Sodium And Potassium

ABSTRACT Two artificial cerebrospinal fluid mixtures, one having a higher than normal sodium, but lower than normal potassium content, the other having a lower than normal sodium, but higher than normal potassium content, were perfused alternately through the cerebral ventricular system of seven dogs, from the right lateral ventricle and down through the third ventricle, aqueduct and fourth ventricle. During this procedure blood was collected through the adrenal vein and the concentration of cortisol (11β, 17,12-trihydroxy-pregn-4-eme-3,20-dione), cortisone (17,21-dihydroxypregn-4-ene-3,11.20-trione), corticosterone (11β,21-dihydroxy-pregn-4-ene3,20-dione). compound S (11-dihydroxy-3,20-dioxo-pregn-4-en-18-al) and aldosterone (11β.21-dihydroxy-3,20-dioxo-pregn-4-en-18-al) determined. A gradual and marked increase in the secretion of all the cortical compounds was observed during the procedure. This pattern was not altered by changing from one of the artificial cerebrospinal fluid mixtures to the other.

Cerebrospinal fluid rhinorrhea and acquired anterior basal encephalocoele in a patient with colloid cyst of the third ventricle

2010 ◽  
Vol 58 (1) ◽  
pp. 156 ◽  
Author(s):  
Chandrasekharan Kesavadas ◽  
TirurRaman Kapilamoorthy ◽  
Gireesh Menon ◽  
KythasandraShivakumar Deepak
Keyword(s):  
Cerebrospinal Fluid ◽  
Third Ventricle ◽  
Colloid Cyst ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
The Third

COLLOID CYSTS OF THE THIRD VENTRICLE: A REVIEW OF SIXTEEN CASES

2021 ◽  
pp. 62-64
Author(s):  
Y Srinivas Rao ◽  
Hemal Chheda ◽  
Ch Surendra ◽  
M V Vijayasekhar ◽  
K Satya Varaprasad
Keyword(s):  
Benign Lesion ◽  
Third Ventricle ◽  
Clinical Manifestations ◽  
Colloid Cyst ◽  
Surgical Approaches ◽  
Imaging Features ◽  
Complete Excision ◽  
Advantages And Disadvantages ◽  
The Third ◽  
Colloid Cysts

BACKGROUND : Colloid cysts are one of the rare brain tumours and are mostly located in the anterosuperior portion of the third ventricle, between the fornix and surround of Foramen of Monroe. OBJECTIVES: Ÿ 1.To review the demographic information & analyse clinical manifestations of patients presenting with colloid cyst of third ventricle. Ÿ 2.To analyze the advantages and disadvantages of various surgical approaches Ÿ 3.To assess the surgical outcome in colloid cyst patients operated by any method. MATERIALS AND METHODS: A retrospective study was performed on 16 patients who presented with a colloid cyst and underwent surgery at the Department of Neurosurgery, King George Hospital, Andhra Medical College between 2013-2018. They were evaluated based on clinical ndings and imaging features, surgical approaches used for resection and their outcomes. RESULTS: Sixteen cases of colloid cyst of the third ventricle were operated upon between 2013-2018. There were seven male and nine female patients with their ages varying between 9 and 62 years old. Nine patients were operated on by using a transcortical trans-ventricular approach, four using the anterior trans-callosal approach and, three patients by using an endoscopic approach. In all patients, complete excision of the lesions was achieved. CONCLUSION: Colloid cysts, though benign, present surgical challenges because of its deep midline location. Complete excision of the colloid cyst carries an excellent prognosis. Surgery is a safe and effective treatment option for this benign lesion.

Neuroendoscopic Aspiration of Blood Clots in the Cerebral Aqueduct and Third Ventricle During Posterior Fossa Surgery in the Prone Position

2018 ◽  
Vol 17 (2) ◽  
pp. 143-148 ◽  
Author(s):  
Alberto Feletti ◽  
Riccardo Stanzani ◽  
Matteo Alicandri-Ciufelli ◽  
Giuliano Giliberto ◽  
Matteo Martinoni ◽  
...  
Keyword(s):  
Prone Position ◽  
Posterior Fossa ◽  
Fourth Ventricle ◽  
Blood Clot ◽  
Third Ventricle ◽  
Cerebral Aqueduct ◽  
Posterior Fossa Surgery ◽  
The Third ◽  
Blood Clots ◽  
Surgical Field

AbstractBACKGROUNDDuring surgery in the posterior fossa in the prone position, blood can sometimes fill the surgical field, due both to the less efficient venous drainage compared to the sitting position and the horizontally positioned surgical field itself. In some cases, blood clots can wedge into the cerebral aqueduct and the third ventricle, and potentially cause acute hydrocephalus during the postoperative course.OBJECTIVETo illustrate a technique that can be used in these cases: the use of a flexible scope introduced through the opened roof of the fourth ventricle with a freehand technique allows the navigation of the fourth ventricle, the cerebral aqueduct, and the third ventricle in order to explore the cerebrospinal fluid pathways and eventually aspirate blood clots and surgical debris.METHODSWe report on one patient affected by an ependymoma of the fourth ventricle, for whom we used a flexible neuroendoscope to explore and clear blood clots from the cerebral aqueduct and the third ventricle after the resection of the tumor in the prone position. Blood is aspirated with a syringe using the working channel of the scope as a sucker.RESULTSA large blood clot that was lying on the roof of the third ventricle was aspirated, setting the ventricle completely free. Other clots were aspirated from the right foramen of Monro and from the optic recess.CONCLUSIONWe describe this novel technique, which represents a safe and efficient way to clear the surgical field at the end of posterior fossa surgery in the prone position. The unusual endoscopic visual perspective and instrument maneuvers are easily handled with proper neuroendoscopic training.

Cyst-ventricle stent as primary or salvage treatment for posterior fossa arachnoid cysts

2011 ◽  
Vol 7 (5) ◽  
pp. 549-556 ◽  
Author(s):  
Daniel H. Fulkerson ◽  
Todd D. Vogel ◽  
Abdul A. Baker ◽  
Neal B. Patel ◽  
Laurie L. Ackerman ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Arachnoid Cyst ◽  
Arachnoid Cysts ◽  
Morbidity Rate ◽  
Initial Symptom ◽  
Salvage Procedure ◽  
The Third ◽  
First Line Therapy ◽  
Posterior Fossa Cyst

Object The optimal treatment of symptomatic posterior fossa arachnoid cysts is controversial. Current options include open or endoscopic resection, fenestration, or cyst-peritoneal shunt placement. There are potential drawbacks with all options. Previous authors have described stenting a cyst into the ventricular system for supratentorial lesions. The current authors have used a similar strategy for posterior fossa cysts. Methods The authors performed a retrospective review of 79 consecutive patients (1993–2010) with surgically treated intracranial arachnoid cysts. Results The authors identified 3 patients who underwent placement of a stent from a posterior fossa arachnoid cyst to a supratentorial ventricle. In 2 patients the stent construct consisted of a catheter placed into a posterior fossa arachnoid cyst and connecting to a lateral ventricle catheter. Both patients underwent stent placement as a salvage procedure after failure of open surgical fenestration. In the third patient a single-catheter cyst-ventricle stent was stereotactically placed. All 3 patients improved clinically. Two patients remained asymptomatic, with radiographic stability in a follow-up period of 1 and 5 years, respectively. The third patient experienced initial symptom resolution with a demonstrable reduction of intracystic pressure. However, he developed recurrent headaches after 2 years. Conclusions Posterior fossa cyst–ventricle stenting offers the benefits of ease of surgical technique and a low morbidity rate. It may also potentially reduce the incidence of shunt-related headaches by equalizing the pressure between the posterior fossa and the supratentorial compartments. While fenestration is considered the first-line therapy for most symptomatic arachnoid cysts, the authors consider cyst-ventricle stenting to be a valuable additional strategy in treating these rare and often difficult lesions.

Critical surgical anatomy of the ventricular system

2010 ◽  
pp. 674-680
Author(s):  
George Samandouras
Keyword(s):  
Fourth Ventricle ◽  
Third Ventricle ◽  
Surgical Anatomy ◽  
Ventricular System ◽  
The Third ◽  
Lateral Ventricles ◽  
System P

Chapter 12.1 covers critical surgical anatomy of the ventricular system, including brief surgical embryology, brief clinical histology, the lateral ventricles, the third ventricle, the fourth ventricle, and major cisterns.

Vasopressin in blood and third ventricle CSF of dogs in chronic experiments

1983 ◽  
Vol 245 (4) ◽  
pp. R541-R548 ◽  
Author(s):  
C. Simon-Oppermann ◽  
D. Gray ◽  
E. Szczepanska-Sadowska ◽  
E. Simon
Keyword(s):  
Cerebrospinal Fluid ◽  
Arginine Vasopressin ◽  
Anterior Part ◽  
Third Ventricle ◽  
Conscious State ◽  
Conscious Dogs ◽  
Inhalation Anesthesia ◽  
Blood Samples ◽  
The Third ◽  
Device Implantation

A device for chronic implantation was developed that allowed sampling of cerebrospinal fluid (CSF) from the anterior part of the third cerebral ventricle (A3V) of dogs in repeated experiments for up to 4 mo. Osmolalities, electrolyte concentrations, and concentrations of arginine vasopressin (AVP) measured with a radioimmunoassay were determined in repeated experiments on the chronically prepared animals under conditions of normal hydration, both in the conscious state and during inhalation anesthesia. In conscious dogs, AVP concentrations in plasma and CSF were 3.3 +/- 0.4 and 21.8 +/- 2.5 pg X ml-1, respectively. During anesthesia without surgical interference, the AVP concentrations in plasma and CSF were increased twofold above the levels obtained in conscious dogs. During the time of observation (180 min) all measured parameters remained constant. The AVP concentrations in plasma and CSF samples collected during the surgical procedure of device implantation were about 10-fold higher than in the samples collected during the conscious state. Thus, in each experimental condition, AVP concentration in the CSF collected from the A3V was consistently higher than that in the simultaneously collected blood samples.

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