scholarly journals Rigid endoscopic surgery of brainstem cavernous malformation on the cerebral aqueduct. Case report

2021 ◽  
Vol 27 (3) ◽  
pp. 54-56
Author(s):  
Orest I. Palamar ◽  
Andriy P. Huk ◽  
Dmytro S. Teslenko ◽  
Dmytro I. Okonskyi ◽  
Ruslan V. Aksyonov
Keyword(s):  
Lateral Ventricle ◽  
Obstructive Hydrocephalus ◽  
Cavernous Angioma ◽  
Anterior Horn ◽  
Cerebral Aqueduct ◽  
Cavernous Angiomas ◽  
Lateral Ventricles ◽  
Transforaminal Approach ◽  
The Right ◽  
The Brain

Cavernous angiomas (malformations) of the brain occur in 0.5% of the population. Most of them are asymptomatic, but due to their anatomical features, namely escape of blood into surrounding tissues, significant neurological symptoms can occur. The deep location of cavernous angiomas in the area of cerebral aqueduct makes surgical intervention difficult. Microsurgical approaches are the gold standard in removal of cavernous angiomas, but they are associated with certain surgical risks in the formation of the surgical corridor. Cavernous malformations in the cerebral aqueduct are a rare subtype. Due to anatomical localization and concomitant obstructive hydrocephalus ІІІ and lateral ventricles, they can be removed by endoscopic frontal transcortical transventricular approach. A 59-year-old patient was diagnosed with cavernous angioma of the brainstem (in the area of cerebral aqueduct) with hemorrhage and the formation of obstructive hydrocephalus ІІІ and lateral ventricles. The operation was performed: removal of the cavernous angioma in the area of cerebral aqueduct by endoscopic frontal transcortical transventricular approach on the right. Additionally, a triventriculocisternostomy was performed. Osteoplastic trepanation with centering at the Kocher’s point in size of 4 × 4 cm and the formation of a free bone flap was performed. The dura mater is cut in an H-shape. Approach to the anterior horn of the right lateral ventricle was performed. An intracerebral retractor was inserted into the anterior horn of the right lateral ventricle. Transforaminal approach to the tuber cinereum was performed - a triventriculocisternostomy was performed. Transforaminal approach to the cerebral aqueduct was performed and the cavernous angioma of the brainstem was removed. In the postoperative period, the patient had a slight deterioration in short-term memory, which regressed 2 weeks after surgery, an increase in oculomotor disorders, in particular persistent diplopia due to moderate paresis of the left oculomotor nerve. Three months after the operation, magnetic resonance imaging of the brain with intravenous contrast enhancement was performed. There are no signs of cavernous angioma. After the operation of frontal transcortical transventricular removal of cavernous angioma in the area of cerebral aqueduct, the compression of the latter was eliminated. Occlusive hydrocephalus regressed, the size of the ventricles decreased. Endoscopic frontal transcortical transventricular approach allows reaching the area of cerebral aqueduct in a less traumatic and minimally invasive manner. This technique is effective due to the low risk of surgical approach complications.

scholarly journals Morphological parallels of communications between the circumventricular system in adolescents

2016 ◽  
Vol 7 (1) ◽  
pp. 37-42
Author(s):  
T. S. Komshuk
Keyword(s):  
Magnetic Resonance ◽  
Ct Scan ◽  
Lateral Ventricle ◽  
Ventricular System ◽  
The Body ◽  
Anterior Horn ◽  
Clinical Hospital ◽  
Iii Ventricle ◽  
The Right ◽  
The Brain

This article presents, based on the example of morphometric study of magnetic resonance tomograms of persons of various ages, the complex of vital characteristics of the cerebrospinal system of the brain in adolescents. The study tested gender characteristics and inter hemispheric asymmetry of the analyzed indexes. An asymmetry of anatomical structures of the right and left hemispheres with the tendency to increase in their sizes in the right hemisphere was found both for males and for females. Females had some age differences in the longitudinal dimension of the III ventricle (this index was lower in older females), the width and index of the IV ventricle was significantly lower in the 18 and 20 year old girls. Objective and methods. The research was conducted on the base of the radiation diagnosis department of Rivne Regional Clinical Hospital on the CT scan General Electric Healthcare Signa MRI 1.5 T and in the office of magnetic resonance imaging of Lutsk City Clinical Hospital on the CT scan Signa Profile Ce Medical System – 1,5 Tl in standard anatomic planes (sagittal, frontal andaxial). Measurements were carried out in persons without visual signs of organic lesions of the brain and skull. Analysis was made of 11 tomograms (males 17–21 years old – 6 persons, females 16–20 years old – 5 persons). In comparing pairs of parameters (of lateral ventricles) the factor of asymmetry was calculated, which is equal to the difference between the right and left lateral ventricles divided by the sum of right and left ventricles indexes (%). The results were processed by methods of descriptional statistics. In young males of this age group a significant increase in the following indicators was identified: the length of the anterior horn of the lateral ventricle on the right side, the length of the body of the lateral ventricle on both sides and the height of the III ventricle. Females had significantly increases in the following parameters: the width of the anterior horn of the lateral ventricle on the right side and the width of the posterior horn of the lateral ventricle on the left side. Consequently, in male adoles cents a parallelism in the formation of various structures of the ventricular system was traced. Since this is a single system, morphological and functional connections between its different components are stored. Mathematical analysis of the values of the structures of ventricular system in females characterize a hormonal influence on its development in adolescents. We can assume that organs which are the part of the circumventricular system (subcommisural organ, subfornical organ, median rise etc.), definitely have the character of anatomical connections between these components. Their functional unity in maintaining the homeostasis of the body is undeniable.

Vascular pressures and cortical blood flow in cavernous angioma of the brain

1990 ◽  
Vol 73 (4) ◽  
pp. 555-559 ◽  
Author(s):  
John R. Little ◽  
Issam A. Awad ◽  
Stephen C. Jones ◽  
Zeyd Y. Ebrahim
Keyword(s):  
Blood Flow ◽  
Cavernous Angioma ◽  
Sitting Position ◽  
Cortical Blood Flow ◽  
Content Type ◽  
Cavernous Angiomas ◽  
Arterial Blood ◽  
Mean Pressure ◽  
Local Cortical Blood Flow ◽  
The Brain

✓ This study was designed to investigate the hemodynamic characteristics of cavernous angiomas of the brain. Five adult patients with a cavernous angioma underwent local cortical blood flow studies and vascular pressure measurements during surgery for the excision of the cavernous angioma. Clinical presentation included headache in four patients, seizures in four patients, and recurring diplopia in one patient. Magnetic resonance imaging demonstrated the cavernous angiomas in all patients and revealed an associated small hematoma in two. Four patients with a cerebral cavernous angioma were operated on in the supine position and the remaining patient, whose lesion involved the brain stem, was operated on in the sitting position. Mean local cortical blood flow (± standard error of the mean) in the cerebral cortex adjacent to the lesion was 60.5 ± 8.3 ml/100 gm/min at a mean PaCO2 of 35.0 ± 0.6 torr. Mean CO2 reactivity was 1.1 ± 0.2 ml/100 gm/min/torr. The local cortical blood flow results were similar to established normal control findings. Mean pressure within the lesion in the patients undergoing surgery while supine was 38.2 ± 0.5 mm Hg; a slight decline in cavernous angioma pressure occurred with a drop in mean systemic arterial blood pressure and PaCO2. Mean pressure in the cavernous angioma in the patient operated on in the sitting position was 7 mm Hg. Jugular compression resulted in a 9-mm Hg rise in cavernous angioma pressure in one supine patient but no change in the patient in the sitting position. Direct microscopic observation revealed slow circulation within the lesions. The hemodynamic features demonstrated in this study indicate that cavernous angiomas are relatively passive vascular anomalies that are unlikely to produce ischemia in adjacent brain. Frank hemorrhage would be expected to be self-limiting because of relatively low driving pressures.

To casuistry of echinococcus of the brain

1904 ◽  
Vol 4 (1-2) ◽  
pp. 106-106
Author(s):  
R D Zelensky
Keyword(s):  
Lateral Ventricle ◽  
The Right ◽  
The Brain

On the dissection of the brain of a patient who died with an unclear diagnosis, it was found that from the lower horn of the right lateral ventricle, stretching it and adjoining the ependymus with its shell, a tumor emanates, which, with projection on the surface, occupies the area of the anterior central crown of the gyrus, the entire part of the temporal.

Recovery of Gonadal Function After Resection of an Oligodendroglioma Localized in the Anterior Horn of the Lateral Ventricle: Relation to Pulsatile Secretion of Luteinizing Hormone

Neurosurgery ◽  
1989 ◽  
Vol 25 (5) ◽  
pp. 820-823 ◽  
Author(s):  
Youichi Saitoh ◽  
Norio Arita ◽  
Toru Hayakawa ◽  
Kazutami Nakao ◽  
Heitaro Mogami
Keyword(s):  
Sexual Dysfunction ◽  
Luteinizing Hormone ◽  
Lateral Ventricle ◽  
Tumor Resection ◽  
Serum Testosterone ◽  
Anterior Horn ◽  
Normal Range ◽  
Pulsatile Secretion ◽  
Lh Pulsatility ◽  
The Right

Abstract A 21-year-old man with an oligodendroglioma in the anterior horn of the right lateral ventricle complained of sexual dysfunction and showed lowered concentrations of serum testosterone (1.1 ng/ml) with normal pituitary function. Human chorionic gonadotropin testing revealed a good testosterone response (1.1 to 4.9 ng/ml) and a clomiphene test revealed no gonadotropin response. Pulsatile secretion of luteinizing hormone (LH) was absent preoperatively. After removal of the tumor, serum concentration of testosterone increased to the normal range, LH pulsatility appeared, and the patient had no complaints of sexual dysfunction. In this patient, the loss of LH pulsatility responsible for his hypogonadism was caused by the lateral ventricle tumor compressing the surrounding structures, and this was corrected by tumor resection.

scholarly journals Radiological imaging of choroid plexus tumors: Systematic approach toward diagnosing a choroid plexus tumor

2021 ◽  
pp. 373-376
Author(s):  
Batra Chakshu ◽  
Kapur Neeru
Keyword(s):  
Choroid Plexus ◽  
Lateral Ventricle ◽  
Histopathological Examination ◽  
Choroid Plexus Papilloma ◽  
Mass Lesion ◽  
Choroid Plexus Tumors ◽  
Common Location ◽  
The Right ◽  
The Brain ◽  
Occipital Horn

Choroid plexus tumors (CPTs) are rare intraventricular tumors comprising approximately 1% of all brain tumors. The common locations are the lateral ventricle (most common location in children), the third and fourth ventricles (most common location in adults), and cerebellopontine angle. Here, we present the case of a 10-month-old child with complaints of fever (99.6F), abnormal eye movements, and bilateral papilledema. Ultrasound cranium of the child revealed a well-defined hyperechoic lesion adjacent to the trigone and occipital horn of the right lateral ventricle. No vascularity could be appreciated on color Doppler. Non-contrast computed tomography of the brain showed a well-defined lobulated mass lesion epicentered at the choroid plexus of the right lateral ventricle which was hyperdense relative to the brain parenchyma with specks of calcification. Contrast-enhanced magnetic resonance imaging showed a solid intensely enhancing lobulated mass lesion with frond-like morphology originating from the choroid plexus of the occipital horn of the right lateral ventricle. Surgical excision of the CPT was done under aseptic conditions. We try to reinforce the ultrasound (USG), CT, and MRI findings of a CPT which ultimately came out to be a choroid plexus papilloma (CPP) on histopathological examination.

Microsurgical removal of paraventricular cavernous angiomas

1981 ◽  
Vol 55 (2) ◽  
pp. 308-311 ◽  
Author(s):  
Eugenio Pozzati ◽  
Giulio Gaist ◽  
Massimo Poppi ◽  
Bernardino Morrone ◽  
Roberto Padovani
Keyword(s):  
Fourth Ventricle ◽  
Third Ventricle ◽  
Cavernous Angioma ◽  
The Other ◽  
Content Type ◽  
Cavernous Angiomas ◽  
The Third ◽  
Microsurgical Approach ◽  
The Right ◽  
Fine Print

✓ Two cases of paraventricular cavernous angiomas are presented. In one, the cavernous angioma was found in the right wall of the fourth ventricle, and in the other in the right thalamus encroaching upon the third ventricle. Both patients had onset of symptoms suggesting a tumor. Good results were obtained by the microsurgical approach to these malformations. The computerized tomography findings typical of cavernous angiomas are reviewed.

scholarly journals MORPHOMETRIC CHARACTERISTICS OF THE VENTRICULAR BRAIN SYSTEMS IN THE ELDERLY AGE

2020 ◽  
Vol 19 (4) ◽  
pp. 15-19
Author(s):  
O. Slobodian ◽  
V. Kryvetskyi ◽  
T. Khmara
Keyword(s):  
Magnetic Resonance ◽  
Human Brain ◽  
Lateral Ventricle ◽  
Hemispheric Asymmetry ◽  
Ventricular System ◽  
The Body ◽  
Elderly Persons ◽  
The Right ◽  
The Brain ◽  
Anterior Posterior

The introduction into medical practice of new methods of neuroimaging - computed and magnetic resonance imaging, has changed the principles of diagnosing morphological changes in the brain and opened up new horizons in the study of its structure. The literature sources provide conflicting and fragmentary data on the anatomical features and morphometric parameters of the parts of the brain, and especially its ventricular system, at different age periods of a person's life. The human brain is characterized by significant age-sex anatomical variability. It differs in men and women in different races, ethnic groups. Signs of difference persist from generation to generation and can be an important characteristic of the variability of the human brain as a species. However, the sex and age features of the structure of the cerebral ventricles, taking into account their individual anatomical variability, have not been sufficiently studied. During morphometric study of magnetic resonance tomograms a comprehensive in vivo characteristic of the cerebral ventricular system in elderly persons is presented. Gender peculiarities and inter-hemispheric asymmetry of relevant indicators are studied. The examinations were conducted in standard anatomical planes (sagittal, frontal and axial) in people with no visual signs of organic lesions of the brain and skull. 38 tomograms of elderly patients were analyzed 38 (14 men and 24 women). 13 indicators of the liquor system of the brain were studied and a significant increase of the following parameters were found in males: the length of the anterior horn of the right lateral ventricle, the length and width of the central part of the lateral ventricle both on the right and left, the length of the lower horn of the lateral ventricle on the left and right, and anterior-posterior size of the lateral ventricle on the right and left. Some of the parameters studied possessed reliable inter-hemispheric asymmetry, namely, in men on the left: the body width of the lateral ventricle, the length and width of the posterior horn of the lateral ventricle, anterior-posterior size of the lateral ventricle; in women – the length of the lower horn of the lateral ventricle on the right.

scholarly journals Surgical approaches to the third ventricle of the brain in children

2021 ◽  
Vol 11 (1) ◽  
pp. 47-54
Author(s):  
Sergey K. Gorelyshev ◽  
Olga A. Medvedeva
Keyword(s):  
Third Ventricle ◽  
Pineal Region ◽  
Anterior Horn ◽  
Surgical Approaches ◽  
Surgical Interventions ◽  
Transcallosal Approach ◽  
Advantages And Disadvantages ◽  
The Third ◽  
Lateral Ventricles ◽  
The Brain

AIM: This study aimed to describe and analyze the advantages and disadvantages of various surgical approaches to neoplasms of the third ventricle of the brain in children. MATERIALS AND METHODS: This study analyzed surgical interventions to the third ventricle in 657 patients, performed at the Academician N.N. Burdenko of the Research Institute of Neurosurgery from 1998 to 2018. These included 375 patients with intra-extraventricular craniopharyngiomas and 282 patients with gliomas of the third ventricle and chiasm. The patients age ranged from 3 mon to 18 years old. RESULTS: The anterior transcallosal approach provides access to the anterior horn and bodies of the lateral ventricles, as well as the third ventricle. The transfornical approach provides more opportunities for access to both the anterior and posterior parts of the third ventricle; however, it has a high risk of trauma to the fornix. The subchoroidal approach provides a very good view of the posterior parts of the third ventricle, especially of the pineal region; however, it has even greater restrictions on viewing its anterior parts. When compared with the transcallosal approach, the transfrontal approach can be used more safely in the absence of hydrocephalus (if the tumor is located in the anterior horn). No specific complications were inherent in a particular approach (seizures were registered in 1%, transient hemiparesis was noted in 10%, and transient memory impairments were revealed in 5% of cases). CONCLUSION: The use of a transcallosal approach is safe even in infants. The transcortical approach is recommended mainly for large tumors of the lateral ventricles, and the transcallosal approach should be used for small tumors of the third ventricle. No specific complications were inherent in a particular approach, and the choice was determined by the assessment of the exact location of the tumor and calculation of the most relevant trajectory for its achievement as well as the aim (biopsy or radical removal). Analysis of magnetic resonance imaging and neuronavigation are significant in the selection of surgical approaches.

scholarly journals Interhemispheric Transcallosal Transforaminal Approach and Microscopic Third Ventriculostomy for Intraventricular Craniopharyngioma Associated with Asymmetric Hydrocephalus: Case Report and Literature Review

Folia Medica ◽  
2019 ◽  
Vol 61 (1) ◽  
pp. 143-147
Author(s):  
Ivo Kehayov ◽  
Vladimir Nakov ◽  
Borislav Kitov ◽  
Hristo Zhelyazkov ◽  
Toma Spiriev
Keyword(s):  
Literature Review ◽  
Obstructive Hydrocephalus ◽  
Third Ventricle ◽  
Visual Field Loss ◽  
Anterior Communicating Artery ◽  
Third Ventriculostomy ◽  
Transforaminal Approach ◽  
The Right ◽  
Total Tumor Removal ◽  
Selection Of

Abstract We report on a case of a solid adamantinomatous variant of craniopharyngioma located entirely within the third ventricle causing asymmetric obstructive hydrocephalus in a 43-year-old male patient. The patient complaints included intermittent severe headache and progressive bilateral visual field loss. Initially, the lesion was accessed via the bifrontal interhemispheric translamina terminalis approach but total removal was not possible due to short anterior communicating artery which limited the exposure. In the second stage, we used the right interhemispheric transcallosal transforaminal approach and achieved total tumor removal followed by microscopic third ventriculostomy. The present article discusses the selection of appropriate surgical approach based on concise literature review that provides favorable surgical management of these rare lesions.

scholarly journals Choroid plexus carcinoma in a cow

2009 ◽  
Vol 39 (7) ◽  
pp. 2229-2232 ◽  
Author(s):  
Fabiano José Ferreira de Sant'Ana ◽  
Adriane Loy Gabriel ◽  
Glaucia Denise Kommers ◽  
Claudio Severo Lombardo de Barros
Keyword(s):  
Epithelial Cells ◽  
Choroid Plexus ◽  
Lateral Ventricle ◽  
Choroid Plexus Carcinoma ◽  
Anatomical Localization ◽  
The Right ◽  
The Brain ◽  
Pituitary Metastasis

A red, firm 3.5x3.0x3.0cm mass was found within the right lateral ventricle, compressing the hippocampus and thalamus of the brain of a 4-year-old cow. The pituitary was enlarged and firm. Histologically, both the brain and pituitary masses consisted of moderately pleomorphic epithelial cells arranged as rosettes or sheets supported by a delicate fibrovascular stroma. Based on anatomical localization, histopathological and immunohistochemical findings, a diagnosis of choroid plexus carcinoma with pituitary metastasis was made.

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