scholarly journals Reinvestigation of the origins of pineal meningiomas based on its related veins and arachnoid membranes

2020 ◽  
Author(s):  
Lei Yu ◽  
Berdimyrat Orazmyradov ◽  
Songtao Qi ◽  
Ye Song ◽  
Luxiong Fang
Keyword(s):  
Posterior Part ◽  
Vertical Motion ◽  
Pineal Region ◽  
Video Data ◽  
Pathological Examination ◽  
Subtotal Resection ◽  
Cerebral Vein ◽  
Straight Sinus ◽  
Velum Interpositum ◽  
Medical University

Abstract Background : A series of patients harboring pineal region meningiomas were respectively analyzed to explore the origin of these tumors and the true meaning of the term "velum interpositum (VI) meningiomas". Methods: 21 patients with pineal meningiomas underwent operation in Nanfang Hospital of Southern Medical University from January 2005 to December 2016 were retrospectively included to analyze the clinical features, imaging findings and surgical video data of these patients. According to the method of literature, the data of this group were also divided into falcotentorial (FT) meningiomas and VI meningiomas, and the differences between the two types of tumors were compared. Results: Among the 21 cases of tumor, there were 12 cases of FT meningiomas, including 4 cases originating from cerebral falx, 4 cases from tentorium of cerebellum and 4 cases from straight sinus; there were 9 cases of VI meningiomas, 7 of which originated from the arachnoid sleeve of the Galen vein, 1 from the posterior part of the internal cerebral vein and 1 from the posterior surface of the pineal gland. Postoperative pathological examination showed meningiomas in all the 21 patients, including 16 cases of total resection and 5 cases of subtotal resection. Postoperatively limitation of binocular vertical motion was found in 3 cases, homotropic hemianopia in 7 cases, hemiplegia in 1 case and death in 1 case. Conclusions : This study suggests that pineal meningiomas are more suitable to be described by FT meningioma and meningiomas of the arachnoid of the pineal region by analyzing the origin of tumors. The term "VI meningiomas" can only reflect a part of meningiomas of the arachnoid of the pineal region. Before the removal of pineal meningiomas, more attention should be paid to the effects of the two types of tumors on the Galen vein and the straight sinus, and the establishment of venous collateral circulation.

scholarly journals Reinvestigation of the origins of pineal meningiomas based on its related veins and arachnoid membranes

2019 ◽  
Author(s):  
Lei Yu ◽  
Berdimyrat Orazmyradov ◽  
Songtao Qi ◽  
Ye Song ◽  
Luxiong Fang
Keyword(s):  
Posterior Part ◽  
Vertical Motion ◽  
Pineal Region ◽  
Video Data ◽  
Pathological Examination ◽  
Subtotal Resection ◽  
Cerebral Vein ◽  
Straight Sinus ◽  
Velum Interpositum ◽  
Medical University

Abstract Background: A series of patients harboring pineal region meningiomas were respectively analyzed to explore the origin of these tumors and the true meaning of the term "velum interpositum (VI) meningiomas".Methods: 21 patients with pineal meningiomas underwent operation in Nanfang Hospital of Southern Medical University from January 2005 to December 2016 were retrospectively included to analyze the clinical features, imaging findings and surgical video data of these patients. According to the method of literature, the data of this group were also divided into falcotentorial (FT) meningiomas and VI meningiomas, and the differences between the two types of tumors were compared.Results: Among the 21 cases of tumor, there were 12 cases of FT meningiomas, including 4 cases originating from cerebral falx, 4 cases from tentorium of cerebellum and 4 cases from straight sinus; there were 9 cases of VI meningiomas, 7 of which originated from the arachnoid sleeve of the Galen vein, 1 from the posterior part of the internal cerebral vein and 1 from the posterior surface of the pineal gland. Postoperative pathological examination showed meningiomas in all the 21 patients, including 16 cases of total resection and 5 cases of subtotal resection. Postoperatively limitation of binocular vertical motion was found in 3 cases, homotropic hemianopia in 7 cases, hemiplegia in 1 case and death in 1 case.Conclusions: This study suggests that pineal meningiomas are more suitable to be described by FT meningioma and primary pineal meningiomas by analyzing the origin of tumors. The term "VI meningiomas" can not accurately reflect the origin of pineal meningiomas. Before the removal of pineal meningiomas, more attention should be paid to the effects of the two types of tumors on the Galen vein and the straight sinus, and the establishment of venous collateral circulation.

scholarly journals Reinvestigation of the origins of pineal meningiomas based on its related veins and arachnoid membranes

2020 ◽  
Author(s):  
Lei Yu ◽  
Berdimyrat Orazmyradov ◽  
Songtao Qi ◽  
Ye Song ◽  
Luxiong Fang
Keyword(s):  
Posterior Part ◽  
Vertical Motion ◽  
Pineal Region ◽  
Video Data ◽  
Pathological Examination ◽  
Subtotal Resection ◽  
Cerebral Vein ◽  
Straight Sinus ◽  
Velum Interpositum ◽  
Medical University

Abstract Background: A series of patients harboring pineal region meningiomas were respectively analyzed to explore the origin of these tumors and the true meaning of the term "velum interpositum (VI) meningiomas".Methods: 21 patients with pineal meningiomas underwent operation in Nanfang Hospital of Southern Medical University from January 2005 to December 2016 were retrospectively included to analyze the clinical features, imaging findings and surgical video data of these patients. According to the method of literature, the data of this group were also divided into falcotentorial (FT) meningiomas and VI meningiomas, and the differences between the two types of tumors were compared.Results: Among the 21 cases of tumor, there were 12 cases of FT meningiomas, including 4 cases originating from cerebral falx, 4 cases from tentorium of cerebellum and 4 cases from straight sinus; there were 9 cases of VI meningiomas, 7 of which originated from the arachnoid sleeve of the Galen vein, 1 from the posterior part of the internal cerebral vein and 1 from the posterior surface of the pineal gland. Postoperative pathological examination showed meningiomas in all the 21 patients, including 16 cases of total resection and 5 cases of subtotal resection. Postoperatively limitation of binocular vertical motion was found in 3 cases, homotropic hemianopia in 7 cases, hemiplegia in 1 case and death in 1 case.Conclusions: This study suggests that pineal meningiomas are more suitable to be described by FT meningioma and meningiomas of the arachnoid of the pineal region by analyzing the origin of tumors. The term "VI meningiomas" can only reflect a part of meningiomas of the arachnoid of the pineal region. Before the removal of pineal meningiomas, more attention should be paid to the effects of the two types of tumors on the Galen vein and the straight sinus, and the establishment of venous collateral circulation.

Microsurgical Anatomy of the Venous Drainage of the Mesencephalodiencephalic Junction

Neurosurgery ◽  
2004 ◽  
Vol 54 (3) ◽  
pp. 678-686 ◽  
Author(s):  
Patrick Chaynes
Keyword(s):  
Third Ventricle ◽  
Posterior Part ◽  
Pineal Region ◽  
Pineal Body ◽  
Cerebral Vein ◽  
Cerebral Veins ◽  
Microsurgical Anatomy ◽  
Jugular Veins ◽  
Topographic Anatomy ◽  
Adjacent Structures

Abstract OBJECTIVE The veins draining the posterior wall of the third ventricle and its adjacent structures and the posterior part of the midbrain have been the most neglected of the intracranial vascular structures in both the anatomic and neurosurgical literature. During our dissections of the pineal region and the quadrigeminal cistern, we did not always encounter topographic anatomy as described in previous articles. The purpose of this study is to describe the topographic anatomy and normal variations of the specific veins that drain the collicular plate and the pineal body and their adjacent structures with a view to better defining neurosurgical approaches to the pineal region. METHODS The deep cerebral veins draining the pineal body, the collicular plate, and their surrounding neural structures were examined on both sides of 25 adult cadaveric brains. In all specimens, the carotid and vertebral arteries and the jugular veins were perfused with red or blue silicone, respectively, to facilitate dissection under ×3 to ×40 magnification. RESULTS The venous plexus on the dorsal aspect of the collicular plate drains via collicular veins according to three different patterns. These types of drainage are closely related to the existence or absence of the basal vein on one or both sides. CONCLUSION The veins draining the superior and inferior aspects of the pineal body form a superior and an inferior pineal vein that usually drain into the internal or great cerebral vein.

Ependymal cyst producing alpha-fetoprotein

2000 ◽  
Vol 93 (4) ◽  
pp. 682-685 ◽  
Author(s):  
Ryuzaburo Kanazawa ◽  
Kazunari Kogure ◽  
Shushi Kominami ◽  
Shiro Kobayashi ◽  
Akira Teramoto ◽  
...  
Keyword(s):  
Third Ventricle ◽  
Single Layer ◽  
Cystic Mass ◽  
Pineal Region ◽  
Alpha Fetoprotein ◽  
Pathological Examination ◽  
Subtotal Resection ◽  
Content Type ◽  
Serum Alpha Fetoprotein ◽  
Resected Tissue

✓ This 17-year-old man was admitted to the hospital due to progressive headache and diplopia. Neuroradiological studies revealed a cystic mass in the pineal region without a parenchymal lesion. In addition, serum alpha-fetoprotein (AFP) levels were elevated. A cyst-to-third-ventricle and cistern fenestration was performed, but the cyst enlarged 3 months after the first operation. In the second operation, subtotal resection of the cyst was performed. The AFP level in the cyst fluid was very high preoperatively but was decreased postoperatively. The patient was discharged with no neurological deficit. Pathological examination of resected tissue showed a single layer of cuboidal cells that resembled an ependymal structure. The cells were immunoreactive for AFP immunostain, which indicated AFP production from these cells.

Microsurgery of the Third Ventricle: Part 1

Neurosurgery ◽  
1981 ◽  
Vol 8 (3) ◽  
pp. 334-356 ◽  
Author(s):  
Isao Yamamoto ◽  
Albert L. Rhoton ◽  
David A. Peace
Keyword(s):  
Lateral Ventricle ◽  
Anterior Part ◽  
Third Ventricle ◽  
Posterior Part ◽  
Posterior Wall ◽  
Pineal Region ◽  
Circle Of Willis ◽  
Cerebral Vein ◽  
Foramen Of Monro ◽  
3Rd Ventricle

Abstract The 3rd ventricle is one of the most surgically inaccessible areas in the brain. It is impossible to reach its cavity without incising some neural structures. Twenty-five cadaveric brains were examined in detail to evaluate the surgically important relationships of the walls of the 3rd ventricle. The routes through which the 3rd ventricle can be reached are: (a) from above, through the foramen of Monro and the roof after entering the lateral ventricle through the corpus callosum or the cerebral cortex; (b) from anterior, through the lamina terminalis; (c) from below, through the floor if it has been stretched by tumor; and (d) from posterior, through the pineal region or from the posterior part of the lateral ventricle through the crus of the fornix. The posterior part of the circle of Willis and the basilar artery are intimately related to the floor, the anterior part of the circle of Willis and the anterior cerebral and anterior communicating arteries are related to the anterior wall, and the posterior cerebral artery supplies the posterior wall. The deep cerebral venous system is intimately related to the 3rd ventricle; the internal cerebral vein is related to the roof, and the basal vein is related to the floor. The junction of these veins with the great vein forms a formidable obstacle to the operative approach to the pineal gland and the posterior part of the 3rd ventricle.

Intracranial germinoma in the pineal region arising after subtotal resection of epidermoid cyst: case report

2013 ◽  
Vol 30 (5) ◽  
pp. 963-966 ◽  
Author(s):  
Amanda J. Walker ◽  
Minh-Phuong Huynh-Le ◽  
David Nauen ◽  
Ashkan A. Malayeri ◽  
George Jallo ◽  
...  
Keyword(s):  
Case Report ◽  
Epidermoid Cyst ◽  
Pineal Region ◽  
Subtotal Resection ◽  
Intracranial Germinoma

scholarly journals Meningiomas of pineal region in children

2007 ◽  
Vol 65 (4a) ◽  
pp. 1000-1006 ◽  
Author(s):  
Hamilton Matushita ◽  
Fernando Campos Pinto ◽  
José Píndaro Pereira Plese
Keyword(s):  
Clinical Presentation ◽  
Complete Removal ◽  
Pineal Region ◽  
Total Resection ◽  
Long Term Follow Up ◽  
One Year ◽  
Velum Interpositum ◽  
Transtentorial Approach

Meningiomas are uncommon tumors in children and either more rarely encountered in the pineal region. We report two cases of meningioma of the pineal region in children. One of these cases was a five years-old girl and the other a one year-old boy. No specific clinical presentation or tomographic examinations findings was identified before treatment, suggestive of a diagnosis of menigioma. The clinical and laboratory features were very similar to the most common tumors of the pineal region. Prior to the surgery, the histology of these tumors was not suspected. Both patients underwent direct surgery and complete removal was achieved by a suboccipital transtentorial approach. The tumors originated from velum interpositum in both cases. At the follow up, one case presented with recurrence six years later, and she underwent a reoperation with total resection without morbidity. Long-term follow up presented no other recurrences.

scholarly journals Atypical Growth Pattern of an Intraparenchymal Meningioma

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Zhen Zeng ◽  
Tijiang Zhang ◽  
Yihua Zhou ◽  
Xiaoxi Chen
Keyword(s):  
Growth Pattern ◽  
Pineal Region ◽  
Pathological Examination ◽  
Intracranial Meningioma ◽  
Temporal Region ◽  
Right Cerebral Hemisphere ◽  
Dural Attachment ◽  
The Right ◽  
Chinese Male ◽  
Irregular Mass

Meningiomas are the most common primary nonneuroglial extra-axial neoplasms, which commonly present as spherical or oval masses with a dural attachment. Meningiomas without dural attachment are rare and, according to their locations, are classified into 5 varieties, including intraventricular, deep Sylvain fissure, pineal region, intraparenchymal, or subcortical meningiomas. To the best of our knowledge, intraparenchymal meningioma with cerebriform pattern has never been reported. In this paper, we report a 34-year-old Chinese male patient who presented with paroxysmal headaches and progressive loss of vision for 10 months and blindness for 2 weeks. A thorough physical examination revealed loss of bilateral direct and indirect light reflex. No other relevant medical history and neurologic deficits were noted. Computed tomography and magnetic resonance imaging scans showed an irregular mass with a unique cerebriform pattern and extensive peritumoral edema in the parietal-occipital-temporal region of the right cerebral hemisphere. The initial diagnosis was lymphoma. Intraoperatively, the tumor was completely buried in a sulcus in the parietal-occipital-temporal region without connecting to the dura. The histological diagnosis was intracranial meningioma based on pathological examination. Therefore, when an unusual cerebriform growth pattern of a tumor is encountered, an intraparenchymal meningioma should be considered as a differential diagnosis.

scholarly journals Endoscopic-assisted posterior interhemispheric retrocallosal transfalcine approach for microsurgical resection of a pineal region falcotentorial meningioma: operative video and technical nuances

2016 ◽  
Vol 40 (videosuppl1) ◽  
pp. 1 ◽  
Author(s):  
James K. Liu ◽  
Michael A. Cohen
Keyword(s):  
Significant Risk ◽  
Signs And Symptoms ◽  
Lateral Position ◽  
Surgical Anatomy ◽  
Pineal Region ◽  
Definitive Treatment ◽  
Surgical Approaches ◽  
Vein Of Galen ◽  
Straight Sinus ◽  
Microsurgical Resection

Falcotentorial meningiomas are rare tumors of the pineal region that arise from the dural folds where the falx and tentorium meet and are often intimately related to the vein of Galen and straight sinus. These lesions often present with signs and symptoms related to hydrocephalus and brainstem compression. Surgical resection of falcotentorial meningiomas remains the definitive treatment, with a variety of surgical approaches used to resect these lesions. The choice of approach depends on several factors, including the size and location of the tumor relative to the vein of Galen complex. Falcotentorial meningiomas can be technically challenging to remove with significant risk of morbidity because of the close proximity to and occasional invasion of the vein of Galen and straight sinus. In this operative video, the authors demonstrate an illustrative step-by-step technique for endoscopic-assisted microsurgical resection of a falcotentorial meningioma using the posterior interhemispheric retrocallosal transfalcine approach for a superiorly positioned falcotentorial meningioma. The surgical nuances are discussed, including the surgical anatomy, gravity-assisted interhemispheric approach in the lateral position, retrocallosal dissection, transfalcine exposure, tumor removal, and preservation of the vein of Galen complex. In summary, the posterior interhemispheric retrocallosal transfalcine approach is a useful surgical strategy for select superiorly positioned falcotentorial meningiomas.The video can be found here: https://youtu.be/d8mdunsRacs.

Imaging Evaluation of Modified Poppen Approach for Microsurgical Removal of Pineal Lesions

2020 ◽  
Vol 10 (6) ◽  
pp. 1352-1358
Author(s):  
Chuandong Cheng ◽  
Jinlong Wu ◽  
Xiaoyu Ru ◽  
Ying Ji
Keyword(s):  
Postoperative Complications ◽  
Clinical Data ◽  
Tumor Resection ◽  
Occipital Lobe ◽  
Pineal Region ◽  
Subtotal Resection ◽  
Image Evaluation ◽  
Imaging Evaluation ◽  
Anatomical Relationship

Objective: The pineal region is deep, and anatomical relationship is complex. Imaging evaluation can effectively guide all kind of neurosurgery. The aim of this study was to explore the value of image evaluation in pineal region microsurgery via modified Poppen approach. Methods: From January 2008 to December 2017, the imaging and clinical data form 62 patients received microsurgery of pineal lesions via the modified Poppen approach at our Hospital were reviewed. The incidences of postoperative complications were compared between the patients with differences in lesion diameter, tentorial angle and preoperative hydrocephalus. Result: According to the data from image evaluation, all the pineal lesions was removed through modified Poppen approach, with total tumor resection in 48 cases, subtotal resection in 10 cases, and partial resection in 4 cases. After 3 to 12 months follow-up, the complication was found in 13 cases (21.0%), including hemianopia (2 cases), occipital lobe contusion (7 cases), monoparesis (2 cases), intracranial infection (2 cases). The incidences of postoperative hemianopia and monoparesis for patients with a lesion > 4.5 cm were significantly higher than those with a lesion ≤ 4.5 cm (P < 0.05). The incidence of postoperative hemianopia for the patients with a tentorial angle > 60° was significantly higher than for those with a tentorial angle ≤ 60° (P < 0.05). Conclusion: Imaging evaluation is useful for microsurgical removal and prediction of complication for modified Poppen approach of pineal lesions.

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