Anatomical landmarks for hemispherotomy and their clinical application

2004 ◽  
Vol 101 (5) ◽  
pp. 747-755 ◽  
Author(s):  
Hung Tzu Wen ◽  
Albert L. Rhoton ◽  
Raul Marino
Keyword(s):  
Corpus Callosum ◽  
Choroid Plexus ◽  
Frontal Lobe ◽  
Lateral Surface ◽  
Lateral Ventricle ◽  
Central Core ◽  
Anatomical Landmarks ◽  
Content Type ◽  
Occipital Lobes ◽  
Fine Print

Object. The authors introduce the surgical concept of the central core of a hemisphere, from which anatomical structures are disconnected during most current hemispherotomy techniques. They also propose key anatomical landmarks for hemispherotomies that can be used to disconnect the hemisphere from its lateral surface around the insula, through the lateral ventricle toward the midline. Methods. This anatomical study was performed in five adult cadaveric heads following perfusion of the cerebral arteries and veins with colored latex. Anatomical landmarks were used in five hemispheric deafferentations. The central core of a hemisphere consists of extreme, external, and internal capsules; claustrum; lentiform and caudate nuclei; and thalamus. Externally, this core is covered by the insula and surrounded by the fornix, choroid plexus, and lateral ventricle. During most hemispherotomies, the surgeon reaches the lateral ventricle through the frontoparietal opercula or temporal lobe; removes the mesial temporal structures; and disconnects the frontal lobe ahead, the parietal and occipital lobes behind, and the intraventricular fibers of the corpus callosum above the central core. After a temporal lobectomy, the landmarks include the choroid plexus and posterior/ascending portion of the tentorium to disconnect the parietal and occipital lobes, the callosal sulcus or distal anterior cerebral artery (ACA) to sever the intraventricular fibers of the corpus callosum, and the head of the caudate nucleus and ACA to detach the frontal lobe. Conclusions. These landmarks can be used in any hemispherotomy during which a cerebral hemisphere is disconnected from its lateral surface. Furthermore, they can be used to perform any resection around the central core of the hemisphere and the tentorial incisura.

Multiple choroid plexus papillomas of the lateral ventricle distinct from villous hypertrophy

1998 ◽  
Vol 88 (3) ◽  
pp. 581-585 ◽  
Author(s):  
Atsuo Yoshino ◽  
Yoichi Katayama ◽  
Takao Watanabe ◽  
Jun Kurihara ◽  
Shigeyoshi Kimura
Keyword(s):  
Choroid Plexus ◽  
Lateral Ventricle ◽  
The Other ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Content Type ◽  
Left Lateral Ventricle ◽  
The Right ◽  
Choroid Plexus Papillomas ◽  
Fine Print

✓ Except for villous hypertrophy of the choroid plexus that may not be true tumors, multiple choroid plexus papillomas are extremely rare. The authors report a case involving multiple choroid plexus papillomas that were distinct from villous hypertrophy. These lesions were localized, one in the atrium of the right lateral ventricle and the other in the inferior horn of the left lateral ventricle. A review of the literature revealed that this case represented the first reported case of true multiple choroid plexus papillomas documented by findings on magnetic resonance imaging.

Malignant choroid plexus papilloma with extraneural metastasis

1980 ◽  
Vol 52 (2) ◽  
pp. 251-255 ◽  
Author(s):  
Joao B. Valladares ◽  
Robert H. Perry ◽  
Ramanand M. Kalbag
Keyword(s):  
Survival Time ◽  
Choroid Plexus ◽  
Lateral Ventricle ◽  
Choroid Plexus Papilloma ◽  
Content Type ◽  
Long Survival ◽  
Extraneural Metastasis ◽  
Fine Print ◽  
Plexus Papilloma

✓ The authors describe and discuss a case of malignant choroid plexus papilloma originating in the lateral ventricle of an 11-month-old child. Unusual features include a long survival time of 9 years and the presence of an extraneural malignant deposit, probably metastatic in origin.

Carcinoma of the choroid plexus

1982 ◽  
Vol 56 (5) ◽  
pp. 722-727 ◽  
Author(s):  
Duncan B. Carpenter ◽  
W. Jost Michelsen ◽  
Arthur P. Hays
Keyword(s):  
Radiation Therapy ◽  
Rare Disease ◽  
Choroid Plexus ◽  
Young Woman ◽  
Lateral Ventricle ◽  
Total Excision ◽  
Total Removal ◽  
Content Type ◽  
Left Lateral Ventricle ◽  
Fine Print

✓ Carcinoma of the choroid plexus is an extremely rare disease with a particularly virulent course. A case is reported in the left lateral ventricle of a young woman who is well 1 year after total excision of the tumor. The four previously reported patients with this disease who did well (two males and two females) were all children. Three of the four were treated with surgery followed by radiotherapy, and one with surgery alone. Although it appears possible that gross total removal may be curative, radiation therapy is suggested because of the distinct possibility that even the least aggressive-appearing lesions may degenerate and become rapidly fatal. Chemotherapy, although not used in any of the cases reported, is suggested as a possible adjunct in the treatment of this disease.

Interhemispheric cyst of neuroepithelial origin in association with partial agenesis of the corpus callosum

1980 ◽  
Vol 52 (3) ◽  
pp. 399-403 ◽  
Author(s):  
Lillian C. Solt ◽  
John H. N. Deck ◽  
Roger Scott Baim ◽  
Karl TerBrugge
Keyword(s):  
Corpus Callosum ◽  
Adult Patient ◽  
Choroid Plexus ◽  
Ct Angiography ◽  
Computerized Tomography ◽  
Cyst Wall ◽  
Choroid Plexus Epithelium ◽  
Content Type ◽  
Interhemispheric Cyst ◽  
Fine Print

✓ The authors report an adult patient with a symptomatic interhemispheric cyst demonstrated by computerized tomography (CT), angiography, and at surgery. Choroid plexus epithelium was identified arising from the inner aspect of the cyst wall. Partial agenesis of the corpus callosum is postulated on the basis of the CT findings and the presence of choroid plexus in the interhemispheric cyst.

Posterior fossa xanthogranuloma

1979 ◽  
Vol 51 (5) ◽  
pp. 718-722 ◽  
Author(s):  
Jesús Vaquero ◽  
Guillermo Leunda ◽  
José M. Cabezudo ◽  
Manuel de Juan ◽  
José Herrero ◽  
...  
Keyword(s):  
Choroid Plexus ◽  
Computerized Tomography ◽  
Posterior Fossa ◽  
Lateral Ventricle ◽  
Content Type ◽  
Similar Density ◽  
The Right ◽  
Fine Print

✓ A large subdural xanthogranuloma was removed from the posterior fossa of a 53-year-old woman with symptoms of Hand-Schüller-Christian disease. Two additional masses with similar density on computerized tomography were found in the hypothalamus and in the choroid plexus of the right lateral ventricle.

Choroid plexus cyst of the lateral ventricle in an elderly man

1984 ◽  
Vol 60 (2) ◽  
pp. 435-437 ◽  
Author(s):  
Shizuo Hatashita ◽  
Suguru Takagi ◽  
Tokiwa Sakakibara
Keyword(s):  
Choroid Plexus ◽  
Lateral Ventricle ◽  
Focal Epilepsy ◽  
Review Of The Literature ◽  
Total Removal ◽  
Content Type ◽  
The Right ◽  
Choroid Plexus Cyst ◽  
Fine Print ◽  
Subsequent Disappearance

✓ The authors report a case of a symptomatic choroid plexus cyst located in the right lateral ventricle of a 64-year-old man who presented with focal epilepsy. The cyst was diagnosed by computerized tomography, and was proven pathologically at surgery. Total removal was accomplished, with subsequent disappearance of the seizures. A brief review of the literature is included.

Acinar choroid plexus adenoma

1970 ◽  
Vol 33 (5) ◽  
pp. 587-590 ◽  
Author(s):  
Richard L. Davis ◽  
Gerald E. Fox
Keyword(s):  
Choroid Plexus ◽  
Lateral Ventricle ◽  
Content Type ◽  
Cystic Tumors ◽  
Complications Of Surgery ◽  
The Right ◽  
Relationship Of ◽  
The Relationship ◽  
Symptoms And Signs ◽  
Fine Print

✓ Mucin-producing cystic tumors of the choroid plexus are rare and most are papillomas or carcinomas. An acinar choroid plexus adenoma of the right lateral ventricle is described. Symptoms and signs included headache, vomiting, papilledema, and a gait disturbance. The neoplasm was located with ventriculography and totally removed, but the patient died of complications of surgery. The relationship of this tumor to others arising in the choroid plexus is discussed.

Preoperative mapping of the supplementary motor area in patients harboring tumors in the medial frontal lobe

2002 ◽  
Vol 97 (5) ◽  
pp. 1108-1114 ◽  
Author(s):  
Lindsey Nelson ◽  
Samir Lapsiwala ◽  
Victor M. Haughton ◽  
Jane Noyes ◽  
Amir H. Sadrzadeh ◽  
...  
Keyword(s):  
Frontal Lobe ◽  
Supplementary Motor Area ◽  
Motor Area ◽  
Neurological Deficits ◽  
Motor Deficit ◽  
Motor Deficits ◽  
Anatomical Landmarks ◽  
Content Type ◽  
Preoperative Mapping ◽  
Fine Print

Object. Injury to the supplementary motor area (SMA) is thought to be responsible for transient motor and speech deficits following resection of tumors involving the medial frontal lobe. Because direct intraoperative localization of SMA is difficult, the authors hypothesized that functional magnetic resonance (fMR) imaging might be useful in predicting the risk of postoperative deficits in patients who undergo resection of tumors in this region. Methods. Twelve patients who had undergone fMR imaging mapping while performing speech and motor tasks prior to excision of their tumor, that is, based on anatomical landmarks involving the SMA, were included in this study. The distance between the edge of the tumor and the center of SMA activation was measured and was correlated with the risk of incurring postoperative neurological deficits. In every patient, SMA activation was noted in the superior frontal gyrus on preoperative fMR imaging. Two speech and two motor deficits typical of SMA injury were observed in three of the 12 patients. The two speech deficits occurred in patients with tumors involving the dominant hemisphere, whereas one of the motor deficits occurred in a patient with a tumor in the nondominant hemisphere. The risk of developing a postoperative speech or motor deficit was 100% when the distance between the SMA and the tumor was 5 mm or less. When the distance between SMA activation and the lesion was greater than 5 mm, the risk of developing a motor or a speech deficit was 0% (p = 0.0007). Conclusions. Early data from this study indicated that fMR imaging might be useful in localizing the SMA and in determining the risk of postoperative deficits in patients who undergo resection of tumors located in the medial frontal lobe.

Arteriovenous malformation of choroid plexus

1975 ◽  
Vol 42 (4) ◽  
pp. 457-461 ◽  
Author(s):  
Charles J. Hodge ◽  
Robert B. King
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Arteriovenous Malformation ◽  
Choroid Plexus ◽  
Content Type ◽  
Fine Print

✓ The authors describe a patient with subarachnoid hemorrhage from an arteriovenous malformation of the choroid plexus and present a brief review of related reports.

Surgical removal of bilateral papillomas of the choroid plexus of the lateral ventricles with resolution of hydrocephalus

1979 ◽  
Vol 50 (5) ◽  
pp. 677-681 ◽  
Author(s):  
Steven K. Gudeman ◽  
Humbert G. Sullivan ◽  
Michael J. Rosner ◽  
Donald P. Becker
Keyword(s):  
Cerebrospinal Fluid ◽  
Choroid Plexus ◽  
Large Volume ◽  
Surgical Removal ◽  
Tumor Removal ◽  
Content Type ◽  
Lateral Ventricles ◽  
Csf Diversion ◽  
Csf Production ◽  
Fine Print

✓ The authors report a patient with bilateral papillomas of the choroid plexus of the lateral ventricles with documentation of cerebrospinal fluid (CSF) hypersecretion causing hydrocephalus. Special attention is given to the large volume of CSF produced by these tumors (removal of one tumor reduced CSF outflow by one-half) and to the fact that CSF diversion was not required after both tumors were removed. Since tumor removal alone was sufficient to stop the progression of hydrocephalus, we feel that this case supports the concept that elevated CSF production by itself is sufficient to cause hydrocephalus in patients with papillomas of the choroid plexus.

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