scholarly journals Adult gangliocytoma arising within the lateral ventricle: A case report and review of the literature

2022 ◽  
Vol 13 ◽  
pp. 11
Author(s):  
Norah Alarifi ◽  
Marc R. Del Bigio ◽  
Jason Beiko
Keyword(s):  
Lateral Ventricle ◽  
Obstructive Hydrocephalus ◽  
World Health ◽  
Pathological Examination ◽  
Low Grade ◽  
Foramen Of Monro ◽  
Transcallosal Approach ◽  
Pediatric Age Group ◽  
Frontal Horn ◽  
Cns Neoplasms

Background: Gangliocytomas are rare neuronal tumors with an incidence of <1% of all central nervous system (CNS) neoplasms. They occur mostly in the pediatric age group, localizing within the cerebral cortex, most often the temporal lobe. Case Description: We report a case of an intracranial gangliocytoma arising within the lateral ventricle in a 66-year-old female. Magnetic resonance imaging of the brain showed a diffusely enhancing lobulated mass situated within the frontal horn of the right lateral ventricle with extension into the foramen of Monro and obstructive hydrocephalus. The patient underwent an interhemispheric transcallosal approach with gross total resection and relief of her hydrocephalus. Pathological examination showed clusters of highly pleomorphic neuron-like cells without evidence of neoplastic glial cells. Histopathological and immunohistochemistry findings were consistent with the diagnosis of gangliocytoma (World Health Organization Grade 1). Conclusion: Gangliocytomas are rare low-grade CNS neoplasms that can present in an older population within unusual locations and should be included within the differential whenever a suspicious lesion is encountered.

scholarly journals Endoscopic resection of a low-grade ependymoma of the pineal region

2021 ◽  
Vol 12 ◽  
pp. 279
Author(s):  
Claudio Schonauer ◽  
Gianpaolo Jannelli ◽  
Enrico Tessitore ◽  
Adrien Thomas May ◽  
Ramona Guatta ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Continuous Wave ◽  
Obstructive Hydrocephalus ◽  
External Ventricular Drain ◽  
Residual Tumor ◽  
Third Ventriculostomy ◽  
Low Grade ◽  
Endoscopic Removal ◽  
Transcallosal Approach ◽  
Frontal Horn

Background: Full endoscopic resection of solid brain tumors represents a challenge for neurosurgeons. This can be achieved with modern technology and advanced surgical tools. Case Description: A 23-years-old male was referred to our unit with raised intracranial pressure. Head computed tomography and magnetic resonance imaging (MRI) revealed obstructive hydrocephalus and a third ventricle lesion. Endoscopic third ventriculostomy and biopsy were performed, a left frontal external ventricular drain was left in place. A second-look surgery for endoscopic removal was planned. Decision to proceed with an endoscopic removal was supported by the following characteristics found during the first surgery: tumor exophytic, soft texture, scarce vascularity, and low-grade appearance. A rescue strategy for microscopic resection via transcallosal approach was decided. A straight trajectory to the tumor was planned with navigation. A further anterior left frontal burr-hole was performed, and the ventricular system was entered via the left frontal horn. Resection was carried out alternating laser for hemostasis and cutting, endoscopic ultrasonic aspirator, and endoscopic forceps for piecemeal resection. Laser hemostasis and cutting (1 Watt power at tip, continuous wave mode) were useful at the ventricular wall-tumor interface. Relevant landmarks guided the approach and the resection (foramen of Monro, mammillary bodies, aqueduct, pineal and suprapineal recess, and posterior commissure). The surgery was carried uneventfully. Histopathology confirmed a lowgrade ependymoma. Post-operative MRI showed residual tumor within the lower aqueduct. At 3 years follow-up, residual tumor is stable. Conclusion: In selected cases, endoscopic resection for third ventricular tumors is feasible and safe, and represents a valid alternative to microsurgical approaches.

Quantitative anatomical comparison of the ipsilateral and contralateral interhemispheric transcallosal approaches to the lateral ventricle

2018 ◽  
Vol 128 (5) ◽  
pp. 1492-1502 ◽  
Author(s):  
Evgenii Belykh ◽  
Kaan Yağmurlu ◽  
Ting Lei ◽  
Sam Safavi-Abbasi ◽  
Mark E. Oppenlander ◽  
...  
Keyword(s):  
Navigation System ◽  
Lateral Ventricle ◽  
Third Ventricle ◽  
Lateral Wall ◽  
Head Region ◽  
Foramen Of Monro ◽  
Transcallosal Approach ◽  
Caudate Head ◽  
Contralateral Approach ◽  
Frontal Horn

OBJECTIVEThe best approach to deep-seated lateral and third ventricle lesions is a function of lesion characteristics, location, and relationship to the ventricles. The authors sought to examine and compare angles of attack and surgical freedom of anterior ipsilateral and contralateral interhemispheric transcallosal approaches to the frontal horn of the lateral ventricle using human cadaveric head dissections. Illustrative clinical experiences with a contralateral interhemispheric transcallosal approach and an anterior interhemispheric transcallosal transchoroidal approach are also related.METHODSFive formalin-fixed human cadaveric heads (10 sides) were examined microsurgically. CT and MRI scans obtained before dissection were uploaded and fused into the navigation system. The authors performed contralateral and ipsilateral transcallosal approaches to the lateral ventricle. Using the navigation system, they measured areas of exposure, surgical freedom, angles of attack, and angle of view to the surgical surface. Two clinical cases are described.RESULTSThe exposed areas of the ipsilateral (mean [± SD] 313.8 ± 85.0 mm2) and contralateral (344 ± 87.73 mm2) interhemispheric approaches were not significantly different (p = 0.12). Surgical freedom and vertical angles of attack were significantly larger for the contralateral approach to the most midsuperior reachable point (p = 0.02 and p = 0.01, respectively) and to the posterosuperior (p = 0.02 and p = 0.04) and central (p = 0.04 and p = 0.02) regions of the lateral wall of the lateral ventricle. Surgical freedom and vertical angles of attack to central and anterior points on the floor of the lateral ventricle did not differ significantly with approach. The angle to the surface of the caudate head region was less steep for the contralateral (135.6° ± 15.6°) than for the ipsilateral (152.0° ± 13.6°) approach (p = 0.02).CONCLUSIONSThe anterior contralateral interhemispheric transcallosal approach provided a more expansive exposure to the lower two-thirds of the lateral ventricle and striothalamocapsular region. In normal-sized ventricles, the foramen of Monro and the choroidal fissure were better visualized through the lateral ventricle ipsilateral to the craniotomy than through the contralateral approach.

Purely Intraventricular Desmoplastic Infantile Astrocytoma

2021 ◽  
Author(s):  
Giovanni Federico Nicoletti ◽  
Giuseppe Emmanuele Umana ◽  
Carmelo Riolo ◽  
Gaetano Magro ◽  
Giovanni Bartoloni ◽  
...  
Keyword(s):  
Lateral Ventricle ◽  
En Bloc Resection ◽  
External Ventricular Drainage ◽  
Lower Limbs ◽  
World Health ◽  
En Bloc ◽  
Foramen Of Monro ◽  
First Case ◽  
Left Lateral Ventricle ◽  
Cystic Component

AbstractDesmoplastic infantile astrocytomas (DIAs) are rare pediatric tumors characterized by superficial brain cortex involvement, along with the meninges of the supratentorial compartment, and are classified as grade I neoplasms according to the 2016 World Health Organization. A 5-year-old female patient was admitted to our unit with abnormal decorticate posturing, bilateral mydriasis with weak pupillary light reflex, and brisk lower limbs reflexes. Her medical history was unremarkable. Magnetic resonance imaging of the brain revealed a massive lesion with bilateral intraventricular growth mainly prevailing on the left and involving the ipsilateral foramen of Monro. After external ventricular drainage positioning, Dandy's transfrontal transcortical approach to the left lateral ventricle, a meticulous ependymal microsurgical dissection of the lesion was performed, resulting in an excision of the cystic component of the left lateral ventricle. A gross total removal of the lesion was performed with an en bloc resection of the deeper cystic part. Thirty days after surgery, the patient presented with fluent speech, conserved axial, and extremity sensorimotor functions, except a mild central facial paresis which progressively improved. To the best of our knowledge, this is the first case of DIA characterized by purely intraventricular growth. Tumor recurrence, although considered rare, represents an unpredictable event. Therefore, an adequate follow-up must be reserved for each patient.

Lateral Ventricle Tumors: Surgical Strategies According to Tumor Origin and Development— A Series of 72 Cases

2005 ◽  
Vol 56 (suppl_1) ◽  
pp. ONS-36-ONS-45 ◽  
Author(s):  
Vincenzo A. D'Angelo ◽  
Marcelo Galarza ◽  
Domenico Catapano ◽  
Vincenzo Monte ◽  
Michele Bisceglia ◽  
...  
Keyword(s):  
Verbal Memory ◽  
Lateral Ventricle ◽  
Psychiatric Symptoms ◽  
Neuropsychological Testing ◽  
Morbidity Rate ◽  
Motor Deficits ◽  
Low Grade ◽  
Transcallosal Approach ◽  
Tumor Origin ◽  
The Mean

Abstract OBJECTIVE: Optimal surgical management in lateral ventricle tumors remains controversial. We conducted a retrospective study of patients with these lesions treated with a surgical strategy on the basis of tumor origin: primary or secondary ventricular and associated transependymal development. METHODS: A total of 72 patients underwent surgery for lateral ventricle tumors. The mean patient age was 39 years (range, 6 mo to 78 yr). Raised intracranial pressure occurred in 53% of patients, followed by mental disturbances or psychiatric symptoms (32%) and motor deficits (21%). The transcortical approach was used in 44 patients, and an interhemispheric approach was used in 28 patients; a transcallosal approach was used in 16 patients, and a parasplenial approach was used in 12 patients. Neuropsychological tests were performed in selected patients. RESULTS: Total resection was performed in 82% of patients. Sixty-five percent of tumors were benign and low-grade tumors. There was no surgical mortality, and the morbidity rate was 11%. Postoperative epilepsy (5.9%) was significantly increased in the transcortical group. The mean follow-up period was 55 months; 59% of patients achieved good recovery and moderate disability. In postoperative neuropsychological testing sessions, deficits in verbal memory were observed in six patients (8%). Final morbidity correlated well with preoperative clinical condition and pathological diagnosis. CONCLUSION: Lateral ventricle tumors can be treated best by careful selection of the approach according to tumor origin and development. Overall, the transcallosal approach is preferred, but in patients with transependymal growth or large primary or secondary ventricular tumors, the transcortical is a better option.

scholarly journals Rare Case of Young Patient with Intraventricular Angiomatous Meningioma

2021 ◽  
pp. 19-25
Author(s):  
Gabriel Carvalho Heemann ◽  
Vinicius Rosa de Castro ◽  
Normando Guedes Pereira Neto ◽  
Camila Bocchi ◽  
Otavio Garcia Martins ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Lateral Ventricle ◽  
The Body ◽  
Neurological Sequela ◽  
Transcallosal Approach ◽  
Frontal Horn ◽  
Intraventricular Tumors ◽  
The Right ◽  
Clinical Stability

Pediatric meningiomas are rare and account for only 2.2% of CNS tumors. In this age group, they are more frequently located in atypical sites, such as, mainly, the ventricular system, with a frequency of 8.8 to 13.6%. Adding this to the fact that the angiomatous subtype constitutes only 2.1% of all meningiomas, the rarity of the case reported here i s corroborated. We report a 17-year-old female patient diagnosed with intraventricular angiomatous meningioma; she underwent surgical resection of the tumor in the body and frontal horn of the right lateral ventricle, and there was no neurological sequela. With a follow-up of 4 years, there was no recurrence and the patient had clinical stability. Intraventricular tumors usually have slow growth and reach considerable size until they cause symptoms and then are diagnosed. In addition, the tumor’s deep location and proximity to eloquent areas make such tumors an neurosurgical challenge. The angiomatous subtype, due to the presence of hypervascularization (consisting of more than 50% of vascular components), may, in some cases, hinder surgical resection as well as be erroneously diagnosed. However, surgical treatment aimed at total resection of the lesion remains the conduct of choice in the case reported here, especially in patients in the first two decades of life, in which the use of radiation is avoided. Specifically when it comes to the surgery, we chose a transcallosal approach that allows a good transoperative visualization of the lesion when located in the body and frontal horn of the lateral ventricle.

Trapped ventricle after laser ablation of a subependymal giant cell astrocytoma complicated by intraventricular gadolinium extravasation: case report

2018 ◽  
Vol 21 (5) ◽  
pp. 523-527 ◽  
Author(s):  
Michael Karsy ◽  
Daxa M. Patel ◽  
Robert J. Bollo
Keyword(s):  
Laser Ablation ◽  
Giant Cell ◽  
Lateral Ventricle ◽  
Obstructive Hydrocephalus ◽  
Attractive Alternative ◽  
Subependymal Giant Cell Astrocytoma ◽  
Foramen Of Monro ◽  
Delayed Complication ◽  
Effect Of Treatment ◽  
The Right

Magnetic resonance imaging–guided stereotactic laser ablation of intracranial targets, including brain tumors, has expanded dramatically over the past decade, but there have been few reports of complications, especially those occurring in a delayed fashion. Laser ablation of subependymal giant cell astrocytomas (SEGAs) is an attractive alternative to maintenance immunotherapy in some children with tuberous sclerosis complex (TSC); however, the effect of treatment on disease progression and the nature and frequency of potential complications remains largely unknown. The authors report the case of a 5-year-old boy with TSC who underwent stereotactic laser ablation of a SEGA at the right foramen of Monro on 2 separate occasions. After the second ablation, immediate posttreatment MRI revealed gadolinium extravasation from the tumor into the lateral ventricle. Nine months later, the patient presented with papilledema and delayed obstructive hydrocephalus secondary to intraventricular adhesions causing a trapped right lateral ventricle. This was successfully treated with endoscopic septostomy. The authors discuss the potential cause and clinical management of a delayed complication not previously reported after a relatively novel surgical therapy.

scholarly journals LGG-23. EXCELLENT CLINICAL / RADIOLOGICAL RESPONSE TO BRAF INHIBITION IN A YOUNG CHILD WITH IN-OPERABLE SUPRA-SELLAR PILOCYTIC ASTROCYTOMA

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii370-iii371
Author(s):  
Stacy Chapman ◽  
Demitre Serletis ◽  
Colin Kazina ◽  
Mubeen Rafay ◽  
Sherry Krawitz ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Pilocytic Astrocytoma ◽  
Clinical Symptoms ◽  
Obstructive Hydrocephalus ◽  
Braf V600e Mutation ◽  
Braf V600e ◽  
Low Grade ◽  
Dramatic Improvement ◽  
Chemotherapeutic Regimen ◽  
Response To Chemotherapy

Abstract In-operable low grade gliomas (LGG) in the pediatric population continue to present a treatment dilemma. Due to the low-grade nature of these tumors, and variable response to chemotherapy / radiation, the choice of adjuvant treatment is difficult. Overall survival is directly related to the degree of surgical resection, adding complexity to these inoperable tumors. Current chemotherapeutic regimen for these inoperable tumors includes vincristine (VCR) and carboplatin (Carbo). With advancements in the molecular characterization of gliomas, the role of targeted therapy has come into question. We present a 2-year-old female with biopsy proven Pilocytic Astrocytoma (positive BRAF-V600E mutation) involving the hypothalamic/optic chiasm region. She presented with ataxic gait, bi-temporal hemianopia, obstructive hydrocephalus and central hypothyroidism, which progressed to altered consciousness, and right hemiparesis due to location/mass effect of the tumor. She was initially treated with chemotherapy (VCR/Carbo) but her tumor progressed at 6 weeks of treatment. As her tumor was positive for BRAF-V600E mutation, she was started on Dabrafenib monotherapy, resulting in dramatic improvement in her clinical symptoms (able to stand, improved vision), and a 60% reduction in tumor size at 3-months. At 6-months, follow up MRI showed slight increase in the solid portion of the tumor, with no clinical symptoms. We plan to add MEK inhibitor (Trametinib) and continue with Dabrafenib. Our experience and literature review suggests that LGG with BRAF-V600E mutations may benefit from upfront targeted therapy. Prospective clinical trials comparing the efficacy of BRAF inhibitors versus standard chemotherapy in LGG with BRAF mutations are urgently needed.

Neurosurgical management of a giant colloid cyst with atypical clinical and radiological presentation

2014 ◽  
Vol 121 (5) ◽  
pp. 1185-1188 ◽  
Author(s):  
Joel Woodley-Cook ◽  
Jaime L. Martinez ◽  
Anish Kapadia ◽  
David G. Munoz ◽  
Aditya Bharatha ◽  
...  
Keyword(s):  
Vision Loss ◽  
Obstructive Hydrocephalus ◽  
Memory Loss ◽  
Final Diagnosis ◽  
Colloid Cyst ◽  
Ct Scans ◽  
Mr Images ◽  
Diagnostic Dilemma ◽  
Foramen Of Monro ◽  
Histopathological Investigation

The finding of a colloid cyst on neuroimaging is often incidental. These lesions are usually located at the foramen of Monro, are hyperdense on CT scans, and generally demonstrate signal intensity of water on MR images, although this depends on their content. When symptomatic, they frequently present with headaches and nausea due to an obstructive hydrocephalus. The authors describe a case of a giant colloid cyst in a patient presenting with complete left-sided vision loss and progressive memory loss, two very atypical findings in colloid cyst presentation. Imaging findings were also atypical, and this case proved to be a diagnostic dilemma because of its clinical and radiological presentation. Histopathological investigation was of utmost importance in the final diagnosis of a colloid cyst. To the authors' knowledge this colloid cyst is larger than any other described in the literature.

Changes in cognitive function after resection of lesions in the anterior part of the lateral ventricle via an interhemispheric transcallosal approach

2020 ◽  
Vol 79 ◽  
pp. 39-44
Author(s):  
Kosuke Nakajo ◽  
Takehiro Uda ◽  
Takeo Goto ◽  
Hiroki Morisako ◽  
Shugo Nishijima ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Lateral Ventricle ◽  
Anterior Part ◽  
Transcallosal Approach

Validation of Sonographic Fronto-Occipital Ratio Based on Anatomical Landmarks compared to MR/CT-Derived Indexes in Children with Chiari II and Ventriculomegaly

2021 ◽  
Author(s):  
Michele Retrouvey ◽  
Arastoo Vossough ◽  
Alireza Zandifar ◽  
Richard D. Bellah ◽  
Gregory G. Heuer ◽  
...  
Keyword(s):  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Ventricular Volume ◽  
Coronal Plane ◽  
Anatomical Landmarks ◽  
Foramen Of Monro ◽  
Rater Reliability ◽  
Unique Challenge ◽  
Frontal Horn ◽  
Chiari Ii

Introduction: Ultrasound (US) based indexes such as fronto-occipital ratio (FOR) can be used to obtain an acceptable estimation of ventricular volume. Patients with colpocephaly present a unique challenge due to the shape of their ventricles. In the present study, we aim to evaluate the validity and reproducibility of modified US-FOR index in children with Chiari II-related ventriculomegaly. Methods: In this retrospective study, we evaluated Chiari II patients younger than one year who underwent head US and MR or CT scans for ventriculomegaly evaluation. MR/CT based FOR was measured in the axial plane by identifying the widest diameter of frontal horns, occipital horns, and the interparietal diameter (IPD). US based FOR (US-FOR) was measured using the largest diameter based on the following landmarks: frontal horn and IPD in the coronal plane at the level of the foramen of Monro, IPD just superior to the Sylvian fissures, and occipital horn posterior to the thalami and inferior to the superior margins of the thalami. Interclass correlation coefficients (ICC) were used to evaluate inter-rater reliability and Pearson correlation coefficients and Bland-Altman plots were applied to assess agreement between US and other two modalities. Results: Ninety paired US and MR/CT exams were assessed for agreement between US-FOR and MR/CT-FOR measurements. ICC showed an excellent inter-rater reliability for US-FOR (ICC=0.99, p<0.001) and MR/CT-FOR measurements (ICC=0.99, p<0.001). The mean (range) values based on US-FOR showed a slight overestimation in comparison to MR/CT-FOR [0.51 (0.36-0.68) vs 0.46 (0.34-0.64)]. Pearson correlation coefficient showed high cross-modality agreement for the FOR index (r=0.83, p<0.001). Bland-Altman plot showed excellent concordance between US-FOR and MR/CT-FOR with a bias of 0.05 (95% CI, -0.03-0.13) Conclusion: US-FOR in the coronal plane is a comparable tool for evaluating ventriculomegaly in Chiari II patients when compared with MR/CT-FOR, even in the context of colpocephaly.

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