Delineation of the obex by contrast radiography during percutaneous trigeminal tractotomy

1972 ◽  
Vol 36 (1) ◽  
pp. 107-112 ◽  
Author(s):  
John L. Fox
Keyword(s):  
Cerebrospinal Fluid ◽  
Medulla Oblongata ◽  
Fourth Ventricle ◽  
Content Type ◽  
X Ray ◽  
Cisterna Magna ◽  
Contrast Radiography ◽  
Fine Print

✓ Accuracy of percutaneous implantation of an electrode into the descending trigeminal tract can be improved substantially by contrast radiography. A translateral x-ray film taken after 1 cc of Pantopaque emulsified with 1 cc of cerebrospinal fluid has been injected by midline puncture of the cisterna magna will outline the floor of the fourth ventricle, the obex, and the dorsum of the medulla oblongata. Injection is made under mild pressure and with the patient prone. This technique has been used successfully on 12 patients.

Fourth ventriculoceles with extracranial extension

1984 ◽  
Vol 61 (2) ◽  
pp. 348-350 ◽  
Author(s):  
Robert A. Fenstermaker ◽  
Uros Roessmann ◽  
Harold L. Rekate
Keyword(s):  
Cerebrospinal Fluid ◽  
Clinical Outcome ◽  
Fourth Ventricle ◽  
Pathological Findings ◽  
Direct Communication ◽  
Content Type ◽  
Cyst Excision ◽  
Occipital Encephalocele ◽  
Fine Print

✓ The radiographic features and long-term clinical outcome in three patients who presented at birth with a cystic suboccipital mass in direct communication with the fourth ventricle are reviewed. The pathological findings in a fourth infant who died are also discussed. All surviving infants were treated with cyst excision and diversion of cerebrospinal fluid. The prognosis in these children, followed from 6 to 20 years, surpasses that of the more common occipital encephalocele, for which this entity could be mistaken. The morphogenetic implications relative to more common congenital lesions in this location are discussed.

Extraosseous extradural tuberculous granuloma simulating a herniated lumbar disc

1971 ◽  
Vol 35 (4) ◽  
pp. 488-490 ◽  
Author(s):  
S. Balaparameswara Rao ◽  
I. Dinakar ◽  
K. Sreenivasa Rao
Keyword(s):  
Cerebrospinal Fluid ◽  
Granulation Tissue ◽  
Lumbar Disc ◽  
Disc Prolapse ◽  
Content Type ◽  
X Ray ◽  
Herniated Lumbar Disc ◽  
Tuberculous Granuloma ◽  
Fine Print

✓ A 25-year-old man with left-sided sciatica, in whom the cerebrospinal fluid and x-ray films of the spine were normal, was diagnosed as having a L5-S1 disc prolapse. At surgery extradural, extraosseous granulation tissue was removed, which histologically proved to be a tuberculous granuloma.

Ependymomas

1970 ◽  
Vol 33 (4) ◽  
pp. 428-438 ◽  
Author(s):  
Bartolo M. Barone ◽  
Arthur R. Elvidge
Keyword(s):  
Fourth Ventricle ◽  
Malignant Tumors ◽  
Cauda Equina ◽  
Vital Statistics ◽  
Tumor Characteristics ◽  
Intracranial Tumors ◽  
Content Type ◽  
X Ray ◽  
Fine Print

✓ A clinical and pathological survey of 74 histologically verified ependymomas (47 intracranial, 27 spinal) was derived from a total series of 2186 gliomas. Patient ages ranged from 7 months to 64 years. The malignant tumors above the tentorium tended to occur in patients over 22 years. The greatest frequency occurred with 24 tumors in the fourth ventricle and 20 in the region of the cauda equina. The location, symptomatology, objective findings, surgical and x-ray therapy, and vital statistics have been evaluated. There was no correlation between tumor characteristics and preoperative symptomatology. Supplementary x-ray therapy appeared to be beneficial. Seventeen of the 36 patients with benign intracranial tumors and five of the 11 patients with malignant intracranial tumors survive. Fourteen of the 27 patients with spinal ependymomas survive. There was one instance of generalized metastasis in the spinal series and none in the intracranial group.

Bullet within the fourth ventricle

1971 ◽  
Vol 34 (6) ◽  
pp. 805-807 ◽  
Author(s):  
W. Charles ◽  
A. Sternbergh ◽  
Clark Watts ◽  
Kemp Clark
Keyword(s):  
Emergency Room ◽  
Fourth Ventricle ◽  
Foreign Bodies ◽  
Content Type ◽  
Cisterna Magna ◽  
Neurological Improvement ◽  
Parietal Area ◽  
Fine Print

✓ A woman, shot in the left parietal area with a small caliber pistol, appeared moribund upon admission to the emergency room but rapidly stabilized and became more arousable. In the fifth week following injury, a pneumoencephalogram demonstrated the bullet lying free within the fourth ventricle; it was subsequently removed from the cisterna magna without difficulty. The patient has made progressive neurological improvement. Other reports concerning intraventricular foreign bodies are reviewed and discussed.

Sialorrhea from fourth ventricle hydrocephalus

1994 ◽  
Vol 81 (2) ◽  
pp. 297-298 ◽  
Author(s):  
Stefania Filippi ◽  
Pierfrancesco Monaco ◽  
Umberto Godano ◽  
Fabio Calbucci
Keyword(s):  
Cerebrospinal Fluid ◽  
Fourth Ventricle ◽  
Content Type ◽  
Main Symptom ◽  
Cerebrospinal Fluid Diversion ◽  
Fine Print

✓ The case of a 50-year-old man with tetraventricular hypertensive hydrocephalus is presented, remarkable for fourth ventricle dilatation. This patient showed a significant sialorrhea as the main symptom, which is quite unusual. This condition was successfully treated by cerebrospinal fluid diversion. The uncommon features of this case are summarized.

An investigation of structural degradation of cerebrospinal fluid shunt valves performed using scanning electron microscopy and energy-dispersive x-ray microanalysis

2004 ◽  
Vol 100 (3) ◽  
pp. 534-540 ◽  
Author(s):  
Spyros Sgouros ◽  
Susan J. Dipple
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Cerebrospinal Fluid ◽  
Energy Dispersive ◽  
Ventricular Catheter ◽  
Content Type ◽  
X Ray ◽  
Programmable Valve ◽  
Fine Print ◽  
Scanning Electron

Object. Surveys of cerebrospinal fluid (CSF) shunts that have been removed from patients have shown that even when the ventricular catheter is the cause of the obstruction, the valve may be obstructed or underperforming. The aim of this pilot study was to investigate the degradation of shunt valve structure over time due to the deposition of debris. The findings were compared with findings in unused valves. Methods. Scanning electron microscopy was used to visualize the structures of the valves. The items that were examined included two unused and nine explanted cylindrical medium pressure valves, one unused and six explanted Delta 1.5 valves (PS Medical, Goleta, CA), and one explanted Medos Programmable valve (Codman Johnson & Johnson, LeLocle, Switzerland). The valves were cut open, disassembled, and coated in gold. The areas that were analyzed included the main valve chamber, the diaphragm unit, and the antisiphon device. For areas with abnormal deposits, energy-dispersive x-ray microanalysis was performed to establish the chemical composition of the deposits. The reference unused valves had smooth surfaces with no deposits in any areas. All explanted valves had extensive deposits in all surveyed areas. The deposits varied from small clusters of crystals to large areas that displayed a cobblestone appearance. In diaphragm valves the deposits extensively affected the surface of the diaphragm and the gap between the diaphragm and the surrounding case, where normally CSF flows; in the Medos valve the deposits affected in the spring and “staircase” unit. Deposits were present as early as 2 weeks after implantation. On some valves there was a complete film covering the entire outlet of the valve, which formed a cast inside the valve stretching from wall to wall. The deposits consisted mostly of sodium and chloride, but occasionally contained calcium. In all infected and some noninfected valves there was a significant peak of carbon, indicating the presence of protein deposits. Conclusions. It appears that the continuous flow of CSF through shunt valves causes surface deposits of sodium chloride and other crystals on all aspects of the valve, including the outlet pathways. The formation of deposits may be encouraged by the adhesive properties of the materials that constitute the valve parts.

Experimental assessment of phenoxybenzamine in cerebral vasospasm

1979 ◽  
Vol 50 (2) ◽  
pp. 158-163 ◽  
Author(s):  
Richard P. White ◽  
Shang-Po Huang ◽  
A. Ainsworth Hagen ◽  
James T. Robertson
Keyword(s):  
Cerebrospinal Fluid ◽  
Cerebral Vasospasm ◽  
Basilar Artery ◽  
Experimental Assessment ◽  
Content Type ◽  
Cisterna Magna ◽  
Normal Behavior ◽  
Intracisternal Injection ◽  
Original Observation ◽  
Fine Print

✓ The effect of phenoxybenzamine (PBZ) on cerebral vasospasm of the basilar artery induced by the injection of 2 ml of blood into the cisterna magna of dogs was assessed in chronic experiments. The presence of vasospasm was documented arteriographically. In one group of animals, 12 mg/kg of PBZ was given intravenously 2 hours before the intracisternal injection of blood to ascertain whether this drug would prevent the development of vasospasm for 24 hours. In another group of animals a 10−2M solution of PBZ was given intracisternally 15 minutes after vasospasm was produced, and again 24 hours afterward, to determine if the drug would reverse an existing spasm. These drug-treated animals were compared with controls which were treated with saline alone. The results indicate that the drug treatment was not statistically superior to saline in any of the groups studied. The finding that saline injected into the cisterna magna reversed the cerebral vasospasm illustrates the importance of this procedure in evaluating effectiveness of drugs and confirms the original observation that washing the cerebrospinal fluid with saline can terminate an experimentally induced vasospasm. Moreover, the fact that intracisternal injections of saline were more effective when given soon after the establishment of vasospasm than when injected 24 hours afterward supports the conclusion of others that the pathogenesis of cerebral vasospasm changes with time. The results also indicate that the presence of cerebral vasospasm in some animals did not prevent the return of normal behavior.

Documentation of fourth ventricle entrapment by metrizamide ventriculography with CT scanning

1981 ◽  
Vol 55 (5) ◽  
pp. 838-840 ◽  
Author(s):  
Mauricio Collada ◽  
Joseph Kott ◽  
David G. Kline
Keyword(s):  
Cerebrospinal Fluid ◽  
Computerized Tomography ◽  
Fourth Ventricle ◽  
Ct Scanning ◽  
Ct Scans ◽  
Communicating Hydrocephalus ◽  
Content Type ◽  
Ventriculoperitoneal Shunts ◽  
Fine Print

✓ Documentation by metrizamide ventriculography with computerized tomography (CT) of fourth ventricle entrapment is presented. Reevaluation of the cerebrospinal fluid pathways is suggested whenever fourth ventricle enlargment is seen on CT scans of patients with ventriculoperitoneal shunts for communicating hydrocephalus.

Intracranial lipoma

1980 ◽  
Vol 52 (2) ◽  
pp. 234-245 ◽  
Author(s):  
Ekkehard Kazner ◽  
Otto Stochdorph ◽  
Sigurd Wende ◽  
Thomas Grumme
Keyword(s):  
Cerebrospinal Fluid ◽  
Surgical Approach ◽  
Clinical Symptoms ◽  
Ct Scanning ◽  
Shunt Operation ◽  
Content Type ◽  
X Ray ◽  
Intracranial Lipoma ◽  
X Ray Absorption ◽  
Fine Print

✓ Eleven cases of intracranial lipoma, diagnosed during life by computerized tomography (CT) scanning, are presented. Clinical symptoms related to the lesions were present in eight. The CT scan establishes the diagnosis of intracranial lipoma on the basis of typical x-ray absorption and location. Only dermoid cysts and teratomas may produce a similar CT appearance. In cases of intracranial lipoma, a direct surgical approach is seldom necessary, although in certain locations, lipomas may cause blockage of cerebrospinal fluid pathways and require a shunt operation.

A comparative study of epidural and cisternal pressure in dogsM

1982 ◽  
Vol 57 (4) ◽  
pp. 511-514 ◽  
Author(s):  
Leslie P. Ivan ◽  
Sin H. Choo
Keyword(s):  
Cerebrospinal Fluid ◽  
Comparative Study ◽  
Epidural Pressure ◽  
Content Type ◽  
Cisterna Magna ◽  
High Degree ◽  
Fiberoptic Sensor ◽  
Fine Print

✓ The epidural and cisternal pressure was recorded simultaneously in eight dogs. Epidural pressure was monitored with a Ladd fiberoptic sensor, and the cisternal pressure via a Statham transducer and a Grass polygraph. Various pressure levels were compared when mock cerebrospinal fluid was injected into the cisterna magna. The results were analyzed statistically and, within a range of 0 to 70 mm Hg, a high degree of correlation was found between the pressures of the two compartments (r = 0.96 to 1.0).

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