scholarly journals Central neurocytomas of uncommon locations: report of two cases

2006 ◽  
Vol 64 (4) ◽  
pp. 1015-1018 ◽  
Author(s):  
Francinaldo Lobato Gomes ◽  
Luciano Ricardo França ◽  
Samuel Tau Zymberg ◽  
Sérgio Cavalheiro
Keyword(s):  
Differential Diagnosis ◽  
Intracranial Pressure ◽  
Obstructive Hydrocephalus ◽  
Signs And Symptoms ◽  
Pineal Region ◽  
Additional Treatment ◽  
Third Ventriculostomy ◽  
Increased Intracranial Pressure ◽  
The Brain ◽  
Uncommon Location

We report two patients with central neurocytomas at an uncommon location in the brain. The first, a 58-year-old man presenting with signs and symptoms of increased intracranial pressure, had a tumor located at the pineal region. The second, a 21-year-old woman with tumor in the aqueductal region had worsening migraine-like headaches and diplopia. Both patients had obstructive hydrocephalus treated by neuroendoscopic third ventriculostomy and biopsy of the tumors. No additional treatment was done. We conclude that neurocytomas should be considered in the differential diagnosis of tumors located in the pineal and aqueductal regions.

scholarly journals Primary Isolated Lymphoma of the Fourth Ventricle in an Immunocompetent Patient

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Rakan Bokhari ◽  
Ahmad Ghanem ◽  
Mahmoud Alahwal ◽  
Saleh Baeesa
Keyword(s):  
Fourth Ventricle ◽  
Obstructive Hydrocephalus ◽  
Tumor Resection ◽  
Signs And Symptoms ◽  
Immunocompetent Patient ◽  
Third Ventriculostomy ◽  
Increased Intracranial Pressure ◽  
Complete Tumor Resection ◽  
Initial Line ◽  
Complete Tumor

Primary central nervous lymphoma (PCNSL) is a rare variant of extranodal non-Hodgkin's lymphoma with a especially poor prognosis. The diagnosis is usually encountered in immunodeficient patients but is also encountered, albeit uncommonly, in the immunocompetent. We present a 50-year-old male who developed signs and symptoms of increased intracranial pressure. Imaging revealed the presence of a fourth ventricle mass with obstructive hydrocephalus. First, the patient underwent emergency endoscopic third ventriculostomy followed, few days later, by complete tumor resection via a posterior fossa craniotomy. Postoperative histopathology revealed the lesion to be a PCNSL. He received adjuvant chemotherapy and radiation and remained with no recurrence on regular imaging studies for 18-month followup. We report herein the fourth case of isolated PCNSL lesion to the fourth ventricle in the literature and provide the rationale for our belief that craniotomy and tumor resection, if feasible, should be the initial line of management in similar cases to relieve hydrocephalus and achieve the diagnosis.

Benign Cough Headache

Cephalalgia ◽  
2002 ◽  
Vol 22 (10) ◽  
pp. 772-779 ◽  
Author(s):  
CJ Boes ◽  
MS Matharu ◽  
PJ Goadsby
Keyword(s):  
Magnetic Resonance Imaging ◽  
Differential Diagnosis ◽  
Intracranial Pressure ◽  
Primary Headache ◽  
Headache Disorder ◽  
Resonance Imaging ◽  
Increased Intracranial Pressure ◽  
Primary Headache Disorder ◽  
Cough Headache ◽  
The Brain

Benign cough headache is an uncommon primary headache disorder marked by short- lasting attacks of pain triggered by coughing. Magnetic resonance imaging of the brain is required to assure that the cough headache is truly benign. The aetiology of the pain is unclear, but is probably associated with the brief increased intracranial pressure that attends coughing. We have reviewed the clinical features, aetiology, differential diagnosis, management, and prognosis of benign cough headache.

Hemangioma Calcificans in the Fourth Ventricle

Neurosurgery ◽  
1984 ◽  
Vol 14 (6) ◽  
pp. 737-739 ◽  
Author(s):  
Kobayashi Hidenori ◽  
Kawano Hirokazu ◽  
Ito Haruhide ◽  
Hayashi Minoru ◽  
Yamamoto Shinjiro
Keyword(s):  
Computed Tomography ◽  
Intracranial Pressure ◽  
Posterior Fossa ◽  
Clinical Picture ◽  
Fourth Ventricle ◽  
Obstructive Hydrocephalus ◽  
Increased Intracranial Pressure ◽  
X Ray ◽  
4Th Ventricle

Abstract A case of hemangioma calcificans in the 4th ventricle is reported. Skull x-ray films demonstrated a dense calcification in the posterior fossa. Computed tomography disclosed a hyperdense mass in the 4th ventricle. The clinical picture was of increased intracranial pressure due to obstructive hydrocephalus. An hemangioma calcificans in the 4th ventricle was removed successfully.

scholarly journals SURVIVAL OF POLIOMYELITIC VIRUS IN THE BRAIN OF THE RABBIT

1918 ◽  
Vol 27 (3) ◽  
pp. 443-447 ◽  
Author(s):  
Harold L. Amoss
Keyword(s):  
Intracranial Pressure ◽  
Pressure Effects ◽  
Rabbit Brain ◽  
High Dilution ◽  
Increased Intracranial Pressure ◽  
Intracerebral Inoculation ◽  
Pathological Lesions ◽  
Active Virus ◽  
The Brain

Suspensions of the central nervous tissues of monkeys, containing the active filterable virus of poliomyelitis, may be injected into the brain of rabbits without setting up symptoms, provided the volume of injection does not cause dangerous increased intracranial pressure. Aside from the pressure effects which develop quickly, no other symptoms or pathological lesions are produced by the suspensions. The active virus of poliomyelitis survives in the brain of rabbits for 4 days, as determined by tests in the monkey, into which the excised site of injection in the rabbit brain is reinoculated. It cannot be detected by this test after the expiration of 7 days. The virus of poliomyelitis is unadapted to the rabbit, and neither induces lesions nor survives long in the central nervous organs of that animal. In this respect it differs from certain streptococci cultivated from poliomyelitic tissues. A monkey immunized to streptococcus cultivated from human poliomyelitic nervous tissues yielded a serum which agglutinated the streptococcus in high dilution, but was without neutralizing action on the filtered virus; and the streptococcus-immune monkey was not protected against the effects of an intracerebral inoculation of the filtered virus. The experiments recorded provide additional reasons for concluding that the streptococcus cultivated from cases of poliomyelitis differs essentially from the filterable virus and is not the microbic cause of epidemic poliomyelitis.

Intracranial xanthogranuloma of the dura in Hand-Schüller-Christian disease

1993 ◽  
Vol 78 (2) ◽  
pp. 297-300 ◽  
Author(s):  
Zain Alabedeen B. Jamjoom ◽  
Vinita Raina ◽  
Abdulfattah Al-Jamali ◽  
Abdulhakim B. Jamjoom ◽  
Basim Yacub ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Clinical Features ◽  
Obstructive Hydrocephalus ◽  
Relevant Literature ◽  
Increased Intracranial Pressure ◽  
Falx Cerebri ◽  
Content Type ◽  
Tentorium Cerebelli ◽  
Ultrastructural Studies ◽  
Fine Print

✓ The authors describe a 37-year-old man with the classic clinical features of Hand-Schüller-Christian disease. He presented with symptoms of increased intracranial pressure due to obstructive hydrocephalus secondary to a huge xanthogranuloma involving falx cerebri and tentorium cerebelli. Immunohistochemical and ultrastructural studies failed to demonstrate Langerhans histiocytes, however. The implication of this finding is discussed in light of the recent relevant literature.

One- vs Two-Burr-Hole Technique for Combined Endoscopic Third Ventriculostomy and Pineal Region Biopsy: Volumetric Analysis of Brain at Risk

2020 ◽  
Vol 19 (2) ◽  
pp. 175-180
Author(s):  
Brandon D Liebelt ◽  
Fangxiang Chen ◽  
Antonio Biroli ◽  
Xiaochun Zhao ◽  
Peter Nakaji
Keyword(s):  
At Risk ◽  
Endoscopic Third Ventriculostomy ◽  
Brain Parenchyma ◽  
Pineal Region ◽  
Burr Hole ◽  
Third Ventriculostomy ◽  
Tumor Biopsy ◽  
Burr Holes ◽  
The Brain ◽  
The Ideal

Abstract BACKGROUND Pineal region tumors are associated with the ventricular system. Endoscopic third ventriculostomy (ETV) is often performed at the same time as tumor biopsy. OBJECTIVE To investigate the volume of brain possibly undergoing injury and forniceal stretching during ETV and tumor biopsy. METHODS We performed a retrospective review of preoperative magnetic resonance imagings (MRIs) and computed tomography (CTs) of patients with pineal region masses and used volumetric image-guided navigation to simulate a 1-burr-hole vs a 2-burr-hole approach through the brain parenchyma. We compared the volumes of parenchyma and fornix at the risk of injury. RESULTS The ideal entry point for ETV using 2 burr holes was a mean ± standard deviation (SD) of 25.8 ± 6 mm from the midline and 11.4 ± 9 mm behind the coronal suture. The ideal entry point using 2 burr holes for tumor biopsy was 25.7 ± 8 mm from the midline and 53.7 ± 14 mm anterior to the coronal suture. With 1 burr hole, the mean ± SD volume of brain parenchyma at risk was 852 ± 440 mm3. The volume of brain parenchyma at risk with 2 burr holes was 2159 ± 474 mm3 (P < .001; paired t-test). The use of 1 burr hole predisposed the fornix to 14 ± 3 mm of possible stretch, which was minimized with the 2-burr-hole approach. CONCLUSION Using 1 burr hole for both the ETV and tumor biopsy is less likely to traumatize the brain parenchyma than using 2 burr holes. However, 1 burr hole predisposes the fornix to stretch injury. We recommend tailoring the entry to each patient according to their anatomy rather than using a 1-size-fits-all approach.

scholarly journals Cine Phase-Contrast MR Images Failed to Predict Clinical Outcome Following ETV

2009 ◽  
Vol 36 (5) ◽  
pp. 643-647 ◽  
Author(s):  
Xiao Di ◽  
M. Ragab ◽  
Mark G. Luciano
Keyword(s):  
Brain Stem ◽  
Phase Contrast ◽  
Obstructive Hydrocephalus ◽  
Dynamic Mri ◽  
Magnetic Resonance Images ◽  
Third Ventriculostomy ◽  
Coronal Image ◽  
Significant Difference ◽  
The Brain ◽  
Basal Cisterns

Background:To predict success of endoscopic third ventriculostomy (ETV) in patients with obstructive hydrocephalus, we evaluated pre- and post- operative phase-contrast cine magnetic resonance images (PC MRI) on cerebrospinal fluid (CSF), cine flow in basal cisterns around the brain stem, and cervical medullar junction (CMJ) retrospectively.Methods:The study involved 102 patients with mean age of 36.74±23.25, and F/M = 1.55. All patients had PC MRI taken both pre- and post-operatively. A dynamic MRI video of PC MRI was reviewed at sagittal, axial, and coronal sections to determine cistern flows around the brain stem and CMJ. For quantitative analysis, quadrants were divided around midbrain axially to evaluate interpeduncular, quadrageminal, and ambient cisterns of both sides using scores of 0 to 60. Pre- and post- pontine and CMJ flows were shown in sagittal view and scored 0 to 20, and lateral cerebellopontine cisterns of both sides were measured on coronal image and scored 0 to 20.Results:No significant difference in CSF flow was seen from three individual views and total cine score, or between ETV success and failure groups by multivariate analysis of variance. Kaplan-Meier Analysis and Spearman's Correlation Test produced no relationship between MRI cine flow scores and interval period after surgery to ETV failure.Conclusion:PC MRI cine flow failed to demonstrate significant differences between successful and failed ETV groups. This indicates in addition to achieving an adequate fenestration, CSF pathways beyond the basal cisterns around the brain stem and CMJ may play an essential role in achieving ETV success.

scholarly journals Malignant Rhabdoid Tumour of the Pineal Region

1994 ◽  
Vol 21 (3) ◽  
pp. 273-277 ◽  
Author(s):  
Matthew Muller ◽  
Sherri Lynn Hubbard ◽  
John Provias ◽  
Mark Greenberg ◽  
Laurence E. Becker ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Obstructive Hydrocephalus ◽  
Signs And Symptoms ◽  
Pineal Region ◽  
Mass Lesion ◽  
Raised Intracranial Pressure ◽  
Pathological Features ◽  
Rhabdoid Tumour ◽  
Intratumoral Hemorrhage ◽  
The Central Nervous System

Abstract:A 9-month-old male presented to hospital with signs and symptoms of raised intracranial pressure. A CT scan showed obstructive hydrocephalus from a large pineal region mass lesion into which an intratumoral hemorrhage had occurred. A posterior fossa craniectomy and subtotal excision of the mass lesion were performed. By histopathology, the lesion was a malignant rhabdoid tumour (MRT). Despite surgery and chemotherapy, the tumour grew inexorably, and the patient died four months after the initial diagnosis. MRT is a rare and highly invasive neoplasm which infrequently arises from the central nervous system. This is the first documented case of a MRT arising from the pineal region. The clinical, radiographic, and pathological features of the MRT in this patient are presented.

INTRAOPERATIVE DIRECT THIRD VENTRICULOSTOMY AND AQUEDUCTAL STENTING IN DEEP-SEATED MIDLINE BRAIN TUMOR SURGERY

Neurosurgery ◽  
2009 ◽  
Vol 64 (2) ◽  
pp. 256-267 ◽  
Author(s):  
David I. Pitskhelauri ◽  
Alexander N. Konovalov ◽  
Valeri N. Kornienko ◽  
Natalia K. Serova ◽  
Nikita V. Arutiunov ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Obstructive Hydrocephalus ◽  
Third Ventricle ◽  
Pineal Region ◽  
Third Ventriculostomy ◽  
Success Rates ◽  
Tumor Removal ◽  
The Third ◽  
Total Tumor Removal ◽  
Ventricular Shunting

Abstract OBJECTIVE Surgical resection of deep-seated midline brain tumors does not always resolve obstruction of cerebrospinal fluid pathways, and an additional operation—ventricular shunting—is required. To prevent postoperative obstructive hydrocephalus, we combine tumor removal and internal ventricular shunting in 1 stage. METHODS Between 2000 and 2006, 82 patients with deep-seated midline brain tumors (tumors of the third ventricle, pineal region, thalamus, upper brainstem, and superior half of the fourth ventricle) underwent 84 tumor resections with intraoperative internal ventricular shunting. Two types of intraoperative shunting were performed: direct third ventriculostomy with fenestration of the premammillary membrane of the third ventricle floor and Liliequist's membrane, 53 operations; and aqueductal stenting, 30 operations. In 1 patient, third ventriculostomy and aqueductal stenting were performed simultaneously. RESULTS As most of the tumors had an infiltrative growth pattern, gross total tumor removal was achieved in only 31% of patients in this series. There were no fatal outcomes related to the surgery. Follow-up data were collected in 73 patients (89%) and ranged from 2 to 68 months (median, 16 months). Additional shunting because of inadequate function of stoma or stent was performed in 13 patients at various times after surgery (median, 30 days). The Kaplan-Meier survival analysis demonstrated that at 12 and 24 months the intraoperative direct third ventriculostomy success rates were 67 and 61%, respectively; aqueductal stenting success rates were 93% at both 12 and 24 months. CONCLUSION Intraoperative direct third ventriculostomy and aqueductal stenting under direct visual control were found to be reliable methods of hydrocephalus management in patients with deep-seated midline brain tumors.

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