scholarly journals Fourth ventricle neurocysticercosis presenting with Bruns’ syndrome: A case report

2021 ◽  
Vol 12 ◽  
pp. 616
Author(s):  
Diogo Roque ◽  
José Hipólito-Reis ◽  
Pedro Duarte-Batista ◽  
Maria Manuel Santos
Keyword(s):  
Fourth Ventricle ◽  
Obstructive Hydrocephalus ◽  
Brain Magnetic Resonance Imaging ◽  
Disease Recurrence ◽  
Head Movements ◽  
Gait Ataxia ◽  
Cerebrospinal Fluid Diversion ◽  
Postoperative Mri ◽  
Magnetic Resonance Imaging Mri ◽  
Hydrocephalus Treatment

Background: Neurocysticercosis (NCC) is the most common helminthic infection of the central nervous system. We present a case of the fourth ventricle NCC that presented with Bruns’ syndrome (with headaches worsened by head movements, gait ataxia, and vomiting) and the operative technique used for cyst removal. Case Description: A 39-year-old woman was admitted to the emergency department with moderate-to-severe headaches that got worse in the afternoon and were triggered by head movements, relieved on prone position, and were associated with gait ataxia and vomiting. A brain magnetic resonance imaging (MRI) showed a fourth ventricle cyst, with an eccentric enhancing nodule compatible with a larvae scolex and associated obstructive hydrocephalus. The patient was positioned prone and underwent a microsurgical resection of the cyst without rupture through a telovelar approach to the fourth ventricle. The postoperative MRI confirmed complete cyst removal and resolution of the hydrocephalus. At 12-month follow-up, the patient remains with no signs of disease recurrence. Conclusion: In this report, we depict a case of intraventricular NCC successfully treated with a single surgery, allowing intact cyst removal and achieving effective hydrocephalus treatment with no need to resort to cerebrospinal fluid diversion techniques.

scholarly journals Resolution of syringomyelia in ten cases of "up-and-down Chiari malformation" after posterior fossa decompression

2010 ◽  
Vol 68 (5) ◽  
pp. 694-699 ◽  
Author(s):  
José Alberto Gonçalves da Silva ◽  
Luiz Ricardo Santiago Melo ◽  
Antônio Fernandes de Araújo ◽  
Adailton Arcanjo dos Santos Jr
Keyword(s):  
Magnetic Resonance Imaging ◽  
Fourth Ventricle ◽  
Posterior Fossa Decompression ◽  
Sitting Position ◽  
Resonance Imaging ◽  
Postoperative Mri ◽  
Hindbrain Herniation ◽  
Preoperative Magnetic Resonance ◽  
Large Opening ◽  
Magnetic Resonance Imaging Mri

The authors describe ten cases of syringomyelia without hindbrain herniation depicted by preoperative magnetic resonance imaging (MRI) in supine position. However, the herniation was observed in all cases during the operation with the patient in sitting position. The postoperative MRI revealed an intense reduction of the syrinx in all patients, as well as it was also observed a clinical amelioration in all cases. The surgical treatment was based on a large craniectomy with the patient in sitting position, tonsillectomy, large opening of the fourth ventricle and duraplasty with creation of a large cisterna magna.

Retrocerebellar Ependymal Cyst Presenting with Obstructive Hydrocephalus in an Infant

2020 ◽  
Author(s):  
Irene Panero Pérez ◽  
Pablo Martin Munarriz ◽  
Aurelio Hernandez Lain ◽  
Carla Eiriz Fernández ◽  
Daniel Garcia Pérez ◽  
...  
Keyword(s):  
Fourth Ventricle ◽  
Obstructive Hydrocephalus ◽  
Outlet Obstruction ◽  
Histopathological Study ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Benign Lesions ◽  
Microsurgical Fenestration ◽  
Rare Location ◽  
Magnetic Resonance Imaging Mri

AbstractIntracranial ependymal cysts (ECs) are rare benign lesions. They are frequently asymptomatic and arise in the supratentorial regions. Retrocerebellar ECs is a rare location. We present a case of 3-months-old infant who developed obstructive hydrocephalus, bulging fontanel, and macrocephaly secondary to a retrocerebellar EC. Magnetic resonance imaging (MRI) showed a large retrocerebellar cyst that compressed the cerebellum and the brainstem, producing fourth ventricle outlet obstruction and supratentorial hydrocephalus. Microsurgical fenestration of the cyst to the obex of the fourth ventricle and a cystic wall biopsy were performed. The procedure improved supratentorial hydrocephalus, as well as the patient's clinical condition. A histopathological study confirmed the diagnosis of an EC.As far as we know, after a thorough review of the literature, this is the first reported case of retrocerebellar EC. It is a rare cause of hydrocephalus due to outlet obstruction of the fourth ventricle. Treatment of the cause itself has been shown to be effective.

Unusual causes of trigeminal neuralgia treated by gamma knife radiosurgery

2002 ◽  
Vol 97 ◽  
pp. 533-535 ◽  
Author(s):  
Jin Woo Chang ◽  
Jae Young Choi ◽  
Young Sul Yoon ◽  
Yong Gou Park ◽  
Sang Sup Chung
Keyword(s):  
Trigeminal Neuralgia ◽  
Gamma Knife ◽  
Fourth Ventricle ◽  
Gamma Knife Radiosurgery ◽  
Brain Magnetic Resonance Imaging ◽  
Resonance Imaging ◽  
Segmental Demyelination ◽  
Content Type ◽  
Clinical Responses ◽  
Fine Print

✓ The purpose of this paper was to present two cases of secondary trigeminal neuralgia (TN) with an unusual origin and lesion location. In two cases TN was caused by lesions along the course of the trigeminal nerve within the pons and adjacent to the fourth ventricle. Both cases presented with typical TN. Brain magnetic resonance imaging revealed linear or wedge-shaped lesions adjacent to the fourth ventricle, extending anterolaterally and lying along the pathway of the intraaxial trigeminal fibers. The involvement of the nucleus of the spinal trigeminal tract and of the principal sensory trigeminal nucleus with segmental demyelination are suggested as possible causes for trigeminal pain in these cases. It is postulated that these lesions are the result of an old viral neuritis. The patients underwent gamma knife radiosurgery and their clinical responses have been encouraging to date.

Fourth Ventricle Outlet Obstruction and Diverticular Enlargement of Luschka Foramina in a Child with Down Syndrome

2020 ◽  
pp. 1-4
Author(s):  
Valentina Orlando ◽  
Pietro Spennato ◽  
Maria De Liso ◽  
Vincenzo Trischitta ◽  
Alessia Imperato ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Fourth Ventricle ◽  
Endoscopic Third Ventriculostomy ◽  
Obstructive Hydrocephalus ◽  
Radiological Finding ◽  
Outlet Obstruction ◽  
Third Ventriculostomy ◽  
Viable Option ◽  
Case Presentation

<b><i>Introduction:</i></b> Hydrocephalus is not usually part of Down syndrome (DS). Fourth ventricle outlet obstruction is a rare cause of obstructive hydrocephalus, difficult to diagnose, because tetraventricular dilatation may suggest a communicant/nonobstructive hydrocephalus. <b><i>Case Presentation:</i></b> We describe the case of a 6-year-old boy with obstructive tetraventricular hydrocephalus, caused by Luschka and Magen­die foramina obstruction and diverticular enlargement of Luschka foramina (the so-called fourth ventricle outlet obstruction) associated with DS. He was treated with endoscopic third ventriculostomy (ETV) without complications, and a follow-up MRI revealed reduction of the ventricles, disappearance of the diverticula, and patency of the ventriculostomy. <b><i>Conclusion:</i></b> Diverticular enlargement of Luschka foramina is an important radiological finding for obstructive tetraventricular hydrocephalus. ETV is a viable option in tetraventricular obstructive hydrocephalus in DS.

scholarly journals Identifying a Common Functional Framework for Apathy Large-Scale Brain Network

2021 ◽  
Vol 11 (7) ◽  
pp. 679
Author(s):  
Vincenzo Alfano ◽  
Mariachiara Longarzo ◽  
Giulia Mele ◽  
Marcello Esposito ◽  
Marco Aiello ◽  
...  
Keyword(s):  
Large Scale ◽  
Brain Magnetic Resonance Imaging ◽  
Brain Network ◽  
Neural Pathways ◽  
Resonance Imaging ◽  
Daily Life Activities ◽  
Functional Differences ◽  
Central Gyrus ◽  
Magnetic Resonance Imaging Mri ◽  
Disease Specific

Apathy is a neuropsychiatric condition characterized by reduced motivation, initiative, and interest in daily life activities, and it is commonly reported in several neurodegenerative disorders. The study aims to investigate large-scale brain networks involved in apathy syndrome in patients with frontotemporal dementia (FTD) and Parkinson’s disease (PD) compared to a group of healthy controls (HC). The study sample includes a total of 60 subjects: 20 apathetic FTD and PD patients, 20 non apathetic FTD and PD patients, and 20 HC matched for age. Two disease-specific apathy-evaluation scales were used to measure the presence of apathy in FTD and PD patients; in the same day, a 3T brain magnetic resonance imaging (MRI) with structural and resting-state functional (fMRI) sequences was acquired. Differences in functional connectivity (FC) were assessed between apathetic and non-apathetic patients with and without primary clinical diagnosis revealed, using a whole-brain, seed-to-seed approach. A significant hypoconnectivity between apathetic patients (both FTD and PD) and HC was detected between left planum polare and both right pre- or post-central gyrus. Finally, to investigate whether such neural alterations were due to the underlying neurodegenerative pathology, we replicated the analysis by considering two independent patients’ samples (i.e., non-apathetic PD and FTD). In these groups, functional differences were no longer detected. These alterations may subtend the involvement of neural pathways implicated in a specific reduction of information/elaboration processing and motor outcome in apathetic patients.

scholarly journals Rosette-Forming Glioneuronal Tumor of the Fourth Ventricle: A Case of Relapse Treated with Proton Beam Therapy

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 903
Author(s):  
Antonella Cacchione ◽  
Angela Mastronuzzi ◽  
Andrea Carai ◽  
Giovanna Stefania Colafati ◽  
Francesca Diomedi-Camassei ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Proton Beam ◽  
Fourth Ventricle ◽  
Histopathological Examination ◽  
Local Level ◽  
Proton Beam Therapy ◽  
Disease Recurrence ◽  
Glioneuronal Tumor ◽  
First Case ◽  
Cystic Component

Rosette-forming glioneuronal tumors (RGNTs) are rare, grade I, central nervous system (CNS) tumors typically localized to the fourth ventricle. We describe a 9-year-old girl with dizziness and occipital headache. A magnetic resonance imaging (MRI) revealed a large hypodense posterior fossa mass lesion in relation to the vermis, with cystic component. Surgical resection of the tumor was performed. A RGNT diagnosis was made at the histopathological examination. During follow-up, the patient experienced a first relapse, which was again surgically removed. Eight months after, MRI documented a second recurrence at the local level. She was a candidate for the proton beam therapy (PBT) program. Three years after the end of PBT, the patient had no evidence of disease recurrence. This report underlines that, although RGNTs are commonly associated with an indolent course, they may have the potential for aggressive behavior, suggesting the need for treatment in addition to surgery. Controversy exists in the literature regarding effective management of RGNTs. Chemotherapy and radiation are used as adjuvant therapy, but their efficacy management has not been adequately described in the literature. This is the first case report published in which PBT was proposed for adjuvant therapy in place of chemotherapy in RGNT relapse.

scholarly journals The majority of natalizumab-treated MS patients have high natalizumab concentrations at time of re-dosing

2017 ◽  
Vol 24 (6) ◽  
pp. 805-810 ◽  
Author(s):  
Zoé LE van Kempen ◽  
Cyra E Leurs ◽  
Birgit I Witte ◽  
Annick de Vries ◽  
Mike P Wattjes ◽  
...  
Keyword(s):  
Body Weight ◽  
Disease Activity ◽  
Brain Magnetic Resonance Imaging ◽  
Serum Concentrations ◽  
Duration Of Treatment ◽  
Treatment Regimens ◽  
Trough Serum ◽  
Natalizumab Treatment ◽  
Magnetic Resonance Imaging Mri ◽  
Relapsing Remitting Multiple Sclerosis

Background: Natalizumab is efficacious in the treatment of relapsing-remitting multiple sclerosis. All patients receive the same treatment regimen of 300 mg every 4 weeks, despite differences in pharmacokinetics between individual patients. Objective: To give neurologists insight into natalizumab concentrations at time of re-dosing, we investigated longitudinal natalizumab concentrations in 80 patients in relation to disease activity, with possible influencing factors. Methods: In a prospective observational cohort study, natalizumab trough serum concentrations were measured in 80 patients. Data on demographics, duration of treatment, Expanded Disability Status Scale, clinical exacerbations, brain magnetic resonance imaging (MRI), and body weight were collected. Results: We measured high (≥10 µg/mL) natalizumab trough concentrations in 94% of patients. Intra-individual concentrations were stable. The spread in concentrations was substantial and did not correlate with disease activity. We found a negative association between natalizumab concentration and body weight (β = −0.30, p = 0.010). Interpretation: The majority of patients showed high natalizumab serum concentrations at time of re-dosing. Alternative treatment regimens could lead to more efficient use of natalizumab, but caution is warranted regarding the possibility of recurrence of disease activity. Prospective clinical trials are needed to establish the safety of extended dose intervals in natalizumab treatment.

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 Preoperative measurements on MRI in Chiari 1 patients fail to predict outcome after decompressive surgery

2021 ◽  
Author(s):  
Miro-Pekka Jussila ◽  
Juho Nissilä ◽  
Minna Vakkuri ◽  
Päivi Olsén ◽  
Jaakko Niinimäki ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
University Hospital ◽  
Resonance Imaging ◽  
Surgical Decision ◽  
Postoperative Mri ◽  
Before And After ◽  
Magnetic Resonance Imaging Mri ◽  
Surgical Decision Making ◽  
Mri Evaluation ◽  
Outcome Of Surgery

Abstract Background The purpose of our study was to research the parameters of magnetic resonance imaging (MRI) that would predict the outcome of surgery in patients with Chiari 1 malformation (CM1) and to evaluate changes in MRI parameters after surgery. Methods Fifty-one patients (19 children, 13 adolescents, and 19 adults) operated on due to CM1 in Oulu University Hospital between 2004 and 2018 were evaluated. Seventeen parameters were measured from the preoperative MRI and 11 from the postoperative MRI. The correlations between the MRI parameters and the clinical variables before and after surgery were analyzed. Results The majority (88.2%) of the patients had favorable surgical outcomes. Postoperatively, subjective symptoms improved in 88.6% of the patients and syringomyelia in 81.8%. The location of the cerebellar tonsils, when measured in relation to the C2 synchondrosis or the end plate, postoperatively moved cranially in 51.0% (n = 26), did not change in 27.4% (n = 14), and moved caudally in 21.6% (n = 11) of the patients. However, neither the location of the tonsils nor any other parameters measured from pre- or postoperative MRI correlated with the patients’ symptoms or surgical outcomes. Conclusions No specific parameters on preoperative MRI evaluation were predictive of the outcome of surgery, emphasizing clinical examination in surgical decision-making. Furthermore, the postoperative MRI parameters did not correlate with the surgical outcomes. Thus, routine postoperative imaging is suggested only for patients with preoperatively diagnosed syringomyelia or worsening of symptoms.

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