Stereotactic transtentorial hiatus ventriculoperitoneal shunting for the sequestered fourth ventricle

1994 ◽  
Vol 80 (4) ◽  
pp. 759-761 ◽  
Author(s):  
José L. Montes ◽  
David B. Clarke ◽  
Jean-Pierre Farmer
Keyword(s):  
Effective Treatment ◽  
Fourth Ventricle ◽  
Content Type ◽  
Ventriculoperitoneal Shunting ◽  
Isolated Fourth Ventricle ◽  
Fine Print

✓ The authors describe a technique of stereotactic transtentorial hiatus ventriculoperitoneal shunting for the treatment of the sequestered fourth ventricle, used successfully in the care of four patients. They recommend it as a safe, effective treatment of patients suffering from an isolated fourth ventricle.

Isolated fourth ventricle as a complication of ventricular shunting

1978 ◽  
Vol 49 (6) ◽  
pp. 910-913 ◽  
Author(s):  
John C. Hawkins ◽  
Harold J. Hoffman ◽  
Robin P. Humphreys
Keyword(s):  
Computerized Tomography ◽  
Fourth Ventricle ◽  
Obstructive Hydrocephalus ◽  
Normal Function ◽  
Shunt Malfunction ◽  
Cerebellar Dysfunction ◽  
Content Type ◽  
Isolated Fourth Ventricle ◽  
Ventricular Shunting ◽  
Fine Print

✓ Signs of cerebellar dysfunction combined with signs suggestive of shunt malfunction developed in three children with obstructive hydrocephalus. Shunt function was normal. In all cases, the cerebellar signs persisted and computerized tomography scans revealed enlargement of the fourth ventricle. Shunting of the fourth ventricle returned the patients to normal function.

Hydromyelic hydrocephalus

1991 ◽  
Vol 74 (3) ◽  
pp. 371-379 ◽  
Author(s):  
Shizuo Oi ◽  
Hiroshi Kudo ◽  
Hiroshi Yamada ◽  
Songyu Kim ◽  
Seiji Hamano ◽  
...  
Keyword(s):  
Fourth Ventricle ◽  
Stage Iv ◽  
Central Canal ◽  
Classification Systems ◽  
Cerebral Ventricles ◽  
Content Type ◽  
Type Iv ◽  
Ventriculoperitoneal Shunting ◽  
Stage Iv Disease ◽  
Fine Print

✓ The clinical features and pathophysiology of specific forms of hydromyelia are analyzed in this report together with the chronological changes of associated hydrocephalus. Nine patients were studied; all had hydromyelia with varying degrees of associated hydrocephalus. Clinically applicable classification systems were used to evaluate the progression of hydrocephalus (Stages I to IV) and to define the compartment isolated after shunting in the previously communicating cerebral ventricles (Types I to IV). Four patients had Stage IV disease (holoneural canal dilatation); one had Stage II and four had Stage I disease (both Stages I and II with supratentorial hydrocephalus). All patients were initially treated by ventriculoperitoneal shunting at an average age of 9.9 years. Five patients had progressive spinal symptoms before or after treatment of their hydrocephalus. Two patients had Type III isolation (an isolated rhombencephalic ventricle) with a functioning ventricular shunt; ventriculography confirmed a communication between the fourth ventricle and the hydromyelia, and both patients improved after placement of a shunt in the fourth ventricle. The remaining patients had Type IV isolation (isolated central canal dilatation) with a functioning ventricular shunt. This study indicates that in some cases the pathophysiology of hydromyelia is closely related to associated hydrocephalus. A new concept of the development of an isolated compartment after shunting is proposed to explain the progression of hydromyelia in these cases.

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.

Pneumocephalus following ventriculoperitoneal shunt

1975 ◽  
Vol 43 (5) ◽  
pp. 631-633 ◽  
Author(s):  
Lawrence H. Pitts ◽  
Charles B. Wilson ◽  
Herbert H. Dedo ◽  
Robert Weyand
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Ventriculoperitoneal Shunt ◽  
Cerebrospinal Fluid Leakage ◽  
Congenital Defects ◽  
Content Type ◽  
Ventriculoperitoneal Shunting ◽  
Tegmen Tympani ◽  
Temporal Bones ◽  
Fine Print

✓ The authors describe a case of massive pneumocephalus following ventriculoperitoneal shunting for hydrocephalus. After multiple diagnostic and surgical procedures, congenital defects in the tegmen tympani of both temporal bones were identified as the sources for entry of air. A functioning shunt intermittently established negative intracranial pressure and allowed ingress of air through these abnormalities; when the shunt was occluded, air did not enter the skull, and there was no cerebrospinal fluid leakage. Repair of these middle ear defects prevented further recurrence of pneumocephalus.

Teratoma of the fourth ventricle

1973 ◽  
Vol 38 (3) ◽  
pp. 355-357 ◽  
Author(s):  
Robert J. Morelli
Keyword(s):  
Fourth Ventricle ◽  
Rare Case ◽  
Surgical Removal ◽  
Malignant Teratoma ◽  
Content Type ◽  
Fine Print

✓ The author reports a rare case in which a primary malignant teratoma presented as an obstructing mass in the fourth ventricle. The tumor was not cystic but well encapsulated, and a gross total surgical removal was accomplished. A fatal recurrence occurred within 3 months.

Intestinal volvulus secondary to a ventriculoperitoneal shunt

1971 ◽  
Vol 35 (1) ◽  
pp. 95-96 ◽  
Author(s):  
Thomas H. Sakoda ◽  
John A. Maxwell ◽  
Charles E. Brackett
Keyword(s):  
Intestinal Obstruction ◽  
Ventriculoperitoneal Shunt ◽  
Unusual Complication ◽  
Content Type ◽  
Intestinal Volvulus ◽  
Silastic Catheter ◽  
Ventriculoperitoneal Shunting ◽  
Catheter Implantation ◽  
Fine Print

✓ Volvulus with intestinal obstruction is an unusual complication of ventriculoperitoneal shunting. It was the most serious of the few complications experienced in 56 cases of intraperitoneal Silastic catheter implantation and probably represented reaction to the peritoneal incision rather than reaction of the tissue to Silastic.

Fourth ventricular schwannoma

1990 ◽  
Vol 73 (5) ◽  
pp. 777-781 ◽  
Author(s):  
Gary Redekop ◽  
Kost Elisevich ◽  
Joseph Gilbert
Keyword(s):  
Fourth Ventricle ◽  
Content Type ◽  
Radiographic Features ◽  
Unusual Location ◽  
Pontomedullary Junction ◽  
Fine Print

✓ A schwannoma arising from the dorsum of the pontomedullary junction and presenting as an exophytic mass in the fourth ventricle is described. A ventricular schwannoma has not previously been reported in the literature. The presenting clinical and radiographic features and the pathology of this tumor are summarized, and an explanation is sought for its unusual location.

Transcerebellomedullary fissure approach with special reference to the methods of dissecting the fissure

2001 ◽  
Vol 94 (2) ◽  
pp. 257-264 ◽  
Author(s):  
Toshio Matsushima ◽  
Tooru Inoue ◽  
Takanori Inamura ◽  
Yoshihiro Natori ◽  
Kiyonobu Ikezaki ◽  
...  
Keyword(s):  
Fourth Ventricle ◽  
Posterior Margin ◽  
Lateral Wall ◽  
Microsurgical Anatomy ◽  
Optimal Method ◽  
Content Type ◽  
Lateral Recess ◽  
Tela Choroidea ◽  
Opening Method ◽  
Fine Print

Object. The purpose of the present study was to refine the transcerebellomedullary fissure approach to the fourth ventricle and to clarify the optimal method of dissecting the fissure to obtain an appropriate operative view without splitting the inferior vermis. Methods. The authors studied the microsurgical anatomy by using formalin-fixed specimens to determine the most appropriate method of dissecting the cerebellomedullary fissure. While dissecting the spaces around the tonsils and making incisions in the ventricle roof, the procedures used to expose each ventricle wall were studied. Based on their findings, the authors adopted the best approach for use in 19 cases of fourth ventricle tumor. The fissure was further separated into two slit spaces on each side: namely the uvulotonsillar and medullotonsillar spaces. The floor of the fissure was composed of the tela choroidea, inferior medullary velum, and lateral recess, which form the ventricle roof. In this approach, the authors first dissected the spaces around the tonsils and then incised the taenia with or without the posterior margin of the lateral recess. These precise dissections allowed for easy retraction of the tonsil(s) and uvula and provided a sufficient view of the ventricle wall such that the deep aqueductal region and the lateral region around the lateral recess could be seen without splitting the vermis. The dissecting method could be divided into three different types, including extensive (aqueduct), lateral wall, and lateral recess, depending on the location of the ventricle wall and the extent of surgical exposure required. Conclusions. When the fissure is appropriately and completely opened, the approach provides a sufficient operative view without splitting the vermis. Two key principles of this opening method are sufficient dissection of the spaces around the tonsil(s) and an incision of the appropriate portions of the ventricle roof. The taenia(e) with or without the posterior margin of the lateral recess(es) should be incised.

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.

Hydrocephalus due to membranous obstruction of the fourth ventricle

1971 ◽  
Vol 35 (6) ◽  
pp. 672-676 ◽  
Author(s):  
A. Loren Amacher ◽  
Larry K. Page
Keyword(s):  
Posterior Fossa ◽  
Fourth Ventricle ◽  
Clinical Findings ◽  
Posterior Fossa Tumor ◽  
Cerebellar Development ◽  
Rare Entity ◽  
Content Type ◽  
Operative Findings ◽  
Membranous Obstruction ◽  
Fine Print

✓ Four patients with hydrocephalus due to membranous obstruction of the fourth ventricle are presented. This rare entity produced radiographic and clinical findings suggestive of posterior fossa tumor. Operative findings included normal cerebellar development and a translucent membrane just above the foramen of Magendie. Etiological possibilities are discussed.

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