A comparative study on ventriculographic and computerized tomography-guided determinations of brain targets in functional stereotaxis

1990 ◽  
Vol 73 (4) ◽  
pp. 565-571 ◽  
Author(s):  
Marwan I. Hariz ◽  
A. Tommy Bergenheim
Keyword(s):  
Comparative Study ◽  
Computerized Tomography ◽  
Third Ventricle ◽  
Ct Scans ◽  
Noninvasive Technique ◽  
Content Type ◽  
Anterior Displacement ◽  
The Third ◽  
Ct Measurements ◽  
Fine Print

✓ Thalamic, pallidal, and hypothalamic targets were determined in 16 patients by a stereotactic computerized tomography (CT) study using a noninvasive technique with Laitinen's Stereoadapter. At surgery, the Stereoadapter was remounted to the head and the stereotactic CT coordinates were transferred to the Stereoguide without radiography. Air ventriculography was then carried out. The positions of the anterior and posterior commissures (AC and PC), the length of the intercommissural (IC) line, the width of the third ventricle, and the stereotactic coordinates of the target were measured on the ventriculograms and compared to the stereotactic CT measurements. The study showed that the width of the third ventricle was significantly larger on the ventriculograms than on the stereotactic CT scans, whereas the length of the IC line was not significantly different. The differences in the coordinates of the target and of the AC and PC were statistically significant only for the anteroposterior (y) coordinate. Both commissures as well as the surgical target lay, on average, 1.0 mm more anteriorly on the ventriculograms than on the stereotactic CT study. It is concluded that air ventriculography may cause slight anterior displacement of the midbrain structures. The surgical coordinates of the targets based on the stereotactic CT study with the Stereoadapter were on average as accurate as those obtained with ventriculography; therefore, ventriculography may become superfluous in functional stereotaxis.

CT-assisted stereotaxic aspiration of colloid cysts of the third ventricle

1985 ◽  
Vol 62 (2) ◽  
pp. 238-242 ◽  
Author(s):  
Juan J. Rivas ◽  
Ramiro D. Lobato
Keyword(s):  
Computerized Tomography ◽  
Third Ventricle ◽  
Ct Scanning ◽  
Ct Scans ◽  
Content Type ◽  
The Third ◽  
Colloid Cysts ◽  
Reproducible Method ◽  
Inner Diameter ◽  
Fine Print

✓ A technique is reported for the stereotaxic evacuation of colloid cysts of the third ventricle using a stereotaxic system adapted for computerized tomography (CT) scanning. This is an accurate, simple, and reproducible method that avoids the risks of direct approaches. Successful intracystic aspiration resulting in the cure of the patient may be difficult when the viscosity of the cyst contents is high. Thus, the authors use a large cannula (1.8 mm in inner diameter) to evacuate cysts that appear hyperdense on CT scans; these seem to contain a thicker colloid material than hypodense or isodense cysts.

Clinicopathological investigation of gyral high density on computerized tomography following severe head injury in children

1995 ◽  
Vol 82 (6) ◽  
pp. 995-1001 ◽  
Author(s):  
Takehide Onuma ◽  
Yasuko Shimosegawa ◽  
Motonobu Kameyama ◽  
Hiroaki Arai ◽  
Kiyoshi Ishii
Keyword(s):  
Computerized Tomography ◽  
Head Trauma ◽  
Brain Atrophy ◽  
High Density ◽  
Ct Scans ◽  
Severe Head Trauma ◽  
Content Type ◽  
Subacute Stage ◽  
Fine Print ◽  
Diffuse Brain

✓ The authors have treated five cases of severe head trauma in children in which abnormally high density along gyri, “gyral high density,” was seen on plain computerized tomography (CT) scans in the subacute stage of the injury. The prognosis in all cases was poor, with either severe disability or a vegetative state as the outcome due to significant brain atrophy following gyral high density. This pathology was classified into three clinical stages: 1) acute stage, cerebral ischemia in which there is diffuse low density of the cerebrum on CT scans (most marked on the 3rd and 4th days); 2) subacute stage, hemorrhagic infarction showing gyral high density on plain CT scans (between 1 and 4 weeks); and 3) chronic stage, brain atrophy (beginning 4 weeks after the trauma). In their consecutive series of head-injured patients (516 children, 1459 adults), the authors did not find gyral high density on CT scan in adults. This is probably due to the fact that adults who suffer the severe head trauma associated with diffuse brain swelling or diffuse brain edema cannot survive, thus making this gyral high density unique to children.

Endoscopic treatment of colloid cysts of the third ventricle

1998 ◽  
Vol 89 (6) ◽  
pp. 1062-1068 ◽  
Author(s):  
M. Samy Abdou ◽  
Alan R. Cohen
Keyword(s):  
Surgical Technique ◽  
Endoscopic Resection ◽  
Endoscopic Treatment ◽  
Third Ventricle ◽  
Content Type ◽  
Stereotactic Aspiration ◽  
The Third ◽  
Endoscopic Evacuation ◽  
Colloid Cysts ◽  
Fine Print

✓ The surgical technique for the endoscopic evacuation of colloid cysts of the third ventricle in 13 patients is described. The authors conclude that endoscopic resection of these lesions is a useful addition to the current surgical repertoire and a viable alternative to stereotactic aspiration or open craniotomy.

Localization of stereotaxic centers by computerized tomographic scanning

1980 ◽  
Vol 53 (6) ◽  
pp. 861-863 ◽  
Author(s):  
Kim J. Burchiel ◽  
George A. Ojemann ◽  
Nicole Bolender
Keyword(s):  
Third Ventricle ◽  
Content Type ◽  
The Third ◽  
Fine Print

✓ A method is described for determining stereotaxic coordinates using computerized tomographic scanning and intraoperative ventriculography of the third ventricle.

Neuroepithelial (colloid) cyst of the third ventricle in identical twins

1986 ◽  
Vol 65 (3) ◽  
pp. 401-403 ◽  
Author(s):  
Abdel Wahab M. Ibrahim ◽  
Hisham Farag ◽  
Mohammed Naguib ◽  
Ezzeldin Ibrahim
Keyword(s):  
Cerebrospinal Fluid ◽  
Obstructive Hydrocephalus ◽  
Third Ventricle ◽  
Colloid Cyst ◽  
Content Type ◽  
The Third ◽  
Colloid Cysts ◽  
Fluid Pathway ◽  
Ocular Signs ◽  
Fine Print

✓ Colloid cysts of the third ventricle are described in middle-aged twin brothers. One of them presented with recurrent attacks of headache. In this patient the cyst had reached a size large enough to obstruct the cerebrospinal fluid pathway, resulting in hydrocephalus. The twin brother, although asymptomatic, was suspected of the anomaly and investigated because of the similarity of his ocular signs. The diagnosis was confirmed by computerized tomography in both the patient and his brother. The latter proved to have a smaller colloid cyst situated anteriorly in the third ventricle with no obstructive hydrocephalus. The patient was successfully operated on, while the brother is still under observation. Both brothers have had bilateral cataracts, retinal detachments, and left lateral rectus palsies. The familial occurrence of colloid cysts and their association with these ocular findings have apparently not been described before.

A new device for endoscopic third ventriculostomy

2000 ◽  
Vol 93 (3) ◽  
pp. 509-512 ◽  
Author(s):  
Philippe Decq ◽  
Caroline Le Guerinel ◽  
Stéphane Palfi ◽  
Michel Djindjian ◽  
Yves Kéravel ◽  
...  
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Third Ventricle ◽  
Third Ventriculostomy ◽  
Content Type ◽  
New Device ◽  
The Third ◽  
Endoscopic Control ◽  
Gentle Pressure ◽  
Single Use ◽  
Fine Print

✓ Since its description by Dandy in 1922, several techniques have been used to perform third ventriculostomy under endoscopic control. Except for the blunt technique, in which the endoscope is used by itself to create the opening in the floor of the third ventricle, the other techniques require more than one instrument to perforate the floor of the ventricle and enlarge the ventriculostomy. The new device described is a sterilizable modified forceps that allows both the opening of the floor and the enlargement of the ventriculostomy in a simple and effective way.The new device has the following characteristics: 1) the tip of the forceps is thin enough to allow the easy perforation of the floor of the ventricle; 2) the inner surface of the jaws is smooth to avoid catching vessels of the basal cistern; and 3) the outer surface of the jaws has indentations that catch the edges of the opening to prevent them from slipping along the instrument's jaws. The ventricle floor is opened by gentle pressure of the forceps, which is slowly opened so that the edges of the aperture are caught by the distal outer indentation of the jaws, leading to an approximately 4-mm opening of the floor. This device has been used successfully in 10 consecutive patients.This new device allows surgeons to perform third ventriculostomy under endoscopic control in a very simple, quick, and effective way, avoiding the need for additional single-use instruments.

The relationship between magnetic resonance imaging findings and clinical manifestations of hypothalamic hamartoma

1999 ◽  
Vol 91 (2) ◽  
pp. 212-220 ◽  
Author(s):  
Kazunori Arita ◽  
Fusao Ikawa ◽  
Kaoru Kurisu ◽  
Masayuki Sumida ◽  
Kunyu Harada ◽  
...  
Keyword(s):  
Mental Retardation ◽  
Magnetic Resonance ◽  
Precocious Puberty ◽  
Third Ventricle ◽  
Clinical Manifestations ◽  
Hypothalamic Hamartoma ◽  
Content Type ◽  
The Third ◽  
The Relationship ◽  
Fine Print

Object. Hypothalamic hamartoma is generally diagnosed based on its magnetic resonance (MR) imaging characteristics and the patient's clinical symptoms, but the relationship between the neuroradiological findings and clinical presentation has never been fully investigated. In this retrospective study the authors sought to determine this relationship.Methods. The authors classified 11 cases of hypothalamic hamartoma into two categories based on the MR findings. Seven cases were the “parahypothalamic type,” in which the hamartoma is only attached to the floor of the third ventricle or suspended from the floor by a peduncle. Four cases were the “intrahypothalamic type,” in which the hamartoma involved or was enveloped by the hypothalamus and the tumor distorted the third ventricle.Six patients with the parahypothalamic type exhibited precocious puberty, which was controlled by a luteinizing hormone—releasing hormone analog, and one patient was asymptomatic. No seizures or mental retardation were observed in this group. All patients with the intrahypothalamic type had medically intractable seizures, and precocious puberty was seen in one. Severe mental retardation and behavioral disorders including aggressiveness were seen in two patients. The seizures were controlled in only one patient, in whom stereotactically targeted irradiation of the lesion was performed.This topology/symptom relationship was reconfirmed in a review of 61 reported cases of hamartoma, in which the MR findings were clearly described. The parahypothalamic type is generally associated with precocious puberty but is unaccompanied by seizures or developmental delay, whereas the intrahypothalamic type is generally associated with seizures. Two thirds of patients with the latter experience developmental delays, and half also exhibit precocious puberty.Conclusions. Classification of hypothalamic hamartomas into these two categories based on MR findings resulted in a clear correlation between symptoms and the subsequent clinical course.

Intracerebral myiasis from Hypoderma bovis larva in a child

1989 ◽  
Vol 71 (6) ◽  
pp. 929-931 ◽  
Author(s):  
Müfit Kalelioğlu ◽  
Gönül Aktürk ◽  
Fadiil Aktürk ◽  
Sezer Ş. Komsuoğlu ◽  
Kayhan Kuzeyü ◽  
...  
Keyword(s):  
Computerized Tomography ◽  
Ct Scans ◽  
Intracerebral Hematoma ◽  
Review Of The Literature ◽  
Content Type ◽  
First Case ◽  
Hypoderma Bovis ◽  
History Of ◽  
Exact Identification ◽  
Fine Print

✓ Cerebral myiasis with a 10-day history of convulsions due to an intracerebral hematoma caused by a Hypoderma bovis larva is reported in an 8-year-old child. Computerized tomography (CT) showed the hematoma in a right parieto-occipital location. The H. bovis larva and the extensive intracerebral hematoma were discovered during surgery. Among human parasitoses, cerebral myiasis is rare: a review of the literature revealed only two reports, one published in 1969 and one in 1980. This is the first case that has been diagnosed as cerebral myiasis with exact identification of the Hypoderma bovis larva both from the CT scans and at surgery in a patient during life.

Communicating hydrocephalus as a cause of aqueductal stenosis

1979 ◽  
Vol 51 (6) ◽  
pp. 812-818 ◽  
Author(s):  
G. Robert Nugent ◽  
Ossama Al-Mefty ◽  
Sam Chou
Keyword(s):  
Clinical Features ◽  
Clinical Picture ◽  
Third Ventricle ◽  
Aqueductal Stenosis ◽  
Communicating Hydrocephalus ◽  
High Grade ◽  
Content Type ◽  
Complete Occlusion ◽  
The Third ◽  
Fine Print

✓ Eleven cases of presumed aqueductal stenosis with onset of symptoms after the first decade were reviewed. Ten patients had complete occlusion and one a high-grade stenosis. In 10, the dilated lateral ventricles caused a marked inferior displacement of the third ventricle. Postshunting diagnostic studies on six of these patients revealed ascent of the third ventricle, and in three of these the aqueduct was shown to be patent. It appears that in some cases of advanced communicating hydrocephalus the descending third ventricle kinks or pinches shut the aqueduct, adding an obstructive component which accelerates the clinical picture. The mechanism and clinical features of this process are discussed.

Treatment of colloid cysts of the third ventricle by stereotaxic microsurgical laser craniotomy

1989 ◽  
Vol 70 (4) ◽  
pp. 525-529 ◽  
Author(s):  
Chad D. Abernathey ◽  
Dudley H. Davis ◽  
Patrick J. Kelly
Keyword(s):  
Third Ventricle ◽  
Total Removal ◽  
Total Resection ◽  
Content Type ◽  
The Third ◽  
Cyst Aspiration ◽  
Colloid Cysts ◽  
Mass Lesions ◽  
Fine Print

✓ The therapeutic strategies employed in the management of anterior third-ventricular mass lesions remain controversial. Resection by conventional craniotomy, whether via a transcallosal or transcortical approach, carries well-known risks and limitations. Alternatively, in this region traditional stereotaxy has been relegated to use with biopsy only or cyst aspiration procedures. Combining aspects of both conventional and stereotaxic techniques has allowed total removal of 12 colloid cysts in six women and six men ranging in age from 25 to 71 years. No mortality and minimal morbidity have been associated with the procedures. There has been no evidence of recurrence in an average follow-up period of 19 months. By coupling the benefits of stereotaxic precision and localization to the microsurgical management of colloid cysts, several rewards have been realized: 1) only a limited cortical dissection is needed; 2) the hazards of callosal or forniceal injury can be avoided; 3) the lesion is easily localized regardless of ventricular size; 4) hemostasis can be readily achieved with bipolar cautery or defocused laser power; and 5) most importantly, a total resection is possible with little risk to the patient. Stereotaxic microsurgical laser craniotomy provides a new option for the management of colloid cysts and other anterior third-ventricular lesions.

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