Occipital Horn of the Lateral Ventricle

Object. Knowledge of normal variations in ventricular morphological features is important in endoscopic neurosurgery. Classically, two elevations are described on the medial wall of the occipital horn of the lateral ventricle: an upper bulb and a lower calcar avis. Nevertheless, a third, as yet unreported elevation may be present at the junction of the medial wall and the floor of the occipital horn. The authors report the frequency with which this third elevation was found in a series of cadaveric brains. Methods. The medial wall of the occipital horn of the lateral ventricle was studied in the three orthogonal planes in 45 formalin-fixed cadaveric hemispheres. The underlying structures responsible for the observed intraventricular prominences were exposed by microdissection. A third elevation was present, lying ventrorostral to the calcar avis, in seven (47%) of the 15 single hemispheres, and bilaterally in six (40%) of the 15 whole brains. After microdissection, a fiber bundle from the splenium of the corpus callosum was seen emerging in the occipital horn at the angle between the tail of the hippocampus and the bulb of the occipital horn. The most rostral fibers fanned out inferolaterally along the floor of the collateral trigone. The larger, posterior part protruded into the medial wall along the ventral border of the calcar avis as far as the tip of the occipital horn. Conclusions. Besides its importance as a variation of normal ventricular morphological features, the close relationship of this accessory intraventricular prominence to the tail of the hippocampus should be kept in mind when intervening neurosurgically so that damage to the underlying commissural fibers can be avoided.

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

Indian Journal of Case Reports ◽

10.32677/ijcr.v7i9.3004 ◽

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.

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Neuroendoscopic Navigated One-Step Removal of Crossed Ventricular Catheter Fragments: Technical Note

Journal of Pediatric Neurology ◽

10.1055/s-0041-1740367 ◽

2021 ◽

Author(s):

Alessandro Calì ◽

Gianluca Scalia ◽

Salvatore Marrone ◽

Carmelo Riolo ◽

Giuseppe Vasta ◽

...

Keyword(s):

Lateral Ventricle ◽

Convective Flow ◽

Congenital Hydrocephalus ◽

Distal Catheter ◽

Wide Range ◽

Catheter Tip ◽

History Of ◽

One Step ◽

The Right ◽

Occipital Horn

Abstract Introduction Neuroendoscopy plays an important role in minimally invasive neurosurgery. The authors reported an interesting case of a pediatric patient with multiple ventriculoperitoneal shunt (VPS) revision surgeries, presenting with VPS infection and with two crossed intraventricular floating catheter fragments, successfully removed through a neuroendoscopic navigated one-step procedure. A literature review regarding this exceedingly rare condition has also been discussed. Case Description An 11-year-old female patient with a history of congenital hydrocephalus was admitted to the emergency department with symptoms of intracranial hypertension, psychomotor agitation, and tetraparesis. She had a history of previous multiple VPS revisions. She had an urgent brain computed tomography scan that documented hydrocephalus; the VPS's intraventricular catheter tip was sited at the level of the right frontal horn. Two small floating catheter fragments, not connected to the VPS, were identified: the first close to the right lateral ventricle at the level of the right occipital horn, the second one between the right occipital horn and the third ventricle. First, she underwent an exteriorization of the distal catheter for VPS. Cerebrospinal fluid examination documented hyperproteinorrachia and a positive culture for Staphylococcus aureus. Then a navigated right transfrontal endoscopic approach to the right lateral ventricle was performed extending to the previous burr hole and achieving a wide range of working angle with a rigid 0-degree lens endoscope. Intermittent irrigation generating convective flow was performed such as to mobilize the catheters tip gently upward, to remove them by grasping. Finally, a whole VPS replacement has been performed. Conclusion Persistence of intraventricular floating catheter fragments can lead to subacute or chronic infections. Neuroendoscopic retrieval represents a safe and effective alternative to a more extensive and invasive surgical approach. However, the exact catheter tip identification, grasping, and removal can be difficult to achieve, due to the technical instrumentation characteristics and altered intraventricular anatomy in chronic congenital hydrocephalus. In our experience, endoscopic convective flow induction through saline irrigation can determine floating intraventricular catheter fragments movement aiming to their identification and subsequent successful endoscopic retrieval.

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A solid mass with a cystic component arising in the occipital horn of the lateral ventricle in an elderly woman

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2009.07.002 ◽

2010 ◽

Vol 17 (2) ◽

pp. 280

Author(s):

Giuseppe Maria Della Pepa ◽

Riccardo Altavilla ◽

Giovanni Sabatino ◽

Alessio Albanese

Keyword(s):

Lateral Ventricle ◽

Elderly Woman ◽

Solid Mass ◽

Cystic Component ◽

Occipital Horn

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INTRAVENTRICULAR DYSEMBRYOPLASTIC NEUROEPITHELIAL TUMOR

Neurosurgery ◽

10.1227/01.neu.0000306114.08540.aa ◽

2007 ◽

Vol 61 (6) ◽

pp. E1332-E1333 ◽

Cited By ~ 8

Author(s):

Nur Altinörs ◽

Tarkan Calisaneller ◽

Salih Gülşen ◽

Özlem Özen ◽

Önder Öngürü

Keyword(s):

Temporal Lobe ◽

Lateral Ventricle ◽

Clinical Presentation ◽

Epileptic Seizures ◽

Dysembryoplastic Neuroepithelial Tumor ◽

Recurrent Tumor ◽

Neuroepithelial Tumors ◽

History Of ◽

The Right ◽

Occipital Horn

Abstract OBJECTIVE The most common localization of dysembryoplastic neuroepithelial tumors (DNTs) is the supratentorial cortex, often in the temporal lobe. However, intraventricular localization of a DNT is extremely rare. CLINICAL PRESENTATION A 30-year-old woman presented with a 1-year history of epileptic seizures. The seizures had not been controlled despite standard doses of antiepileptics. INTERVENTION Neuroimaging results demonstrated a lesion located in the occipital horn of the right lateral ventricle. The lesion was totally removed. Based on histopathological and immunohistochemical evaluation, a DNT was diagnosed. Over the course of the next 8 months, the patient's epileptic seizures were under control. The most recent neuroimaging examinations revealed neither residual nor recurrent tumor. CONCLUSION Because DNTs are surgically curable and neither radiotherapy nor chemotherapy is required after surgery, recognition of an intraventricular DNT in this location is extremely important.

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Flexible endoscopy for management of intraventricular brain tumors in patients with small ventricles

Journal of Neurosurgery Pediatrics ◽

10.3171/2014.7.peds13648 ◽

2014 ◽

Vol 14 (5) ◽

pp. 490-494 ◽

Cited By ~ 7

Author(s):

Hideki Ogiwara ◽

Nobuhito Morota

Keyword(s):

Brain Tumors ◽

Endoscopic Surgery ◽

Retrospective Review ◽

Lateral Ventricle ◽

Fourth Ventricle ◽

Flexible Endoscopy ◽

Pineal Region ◽

Flexible Endoscope ◽

Suprasellar Region ◽

Occipital Horn

Object Endoscopic surgery is generally withheld in patients with small ventricles due to difficulties in ventricular cannulation and intraventricular manipulation. The effectiveness of flexible endoscopy for management of intraventricular brain tumors in patients with small ventricles was evaluated. Methods Forty-five patients who underwent endoscopic surgery with a flexible endoscope for intraventricular brain tumors were divided into small-ventricle and ventriculomegaly groups according to the frontal and occipital horn ratio (FOR). Retrospective review of these cases was performed and achievement of surgical goals and morbidity were assessed. Results Among the 45 patients, there were 14 with small ventricles and 31 with ventriculomegaly. In the smallventricle group, targeted tumors were located in the suprasellar region in 12 patients and in the pineal region in 2. In the ventriculomegaly group, tumors were located in the pineal region in 15 patients, in the suprasellar region in 9, in the lateral ventricle in 4, in the midbrain in 2, and in the fourth ventricle in 1. In the small-ventricle group, ventricular cannulation was successful and the surgical goals were accomplished in all patients. In ventriculomegaly group, sampling of the tumor was not diagnostic due to intraoperative hemorrhage in 1 patient. There were no significant differences in the rate of achieving the surgical goals or the morbidity between the 2 groups. Conclusions Endoscopic surgery using a flexible endoscope is useful for management of intraventricular brain tumors in patients with small ventricles. A flexible endoscope allows excellent maneuverability in introducing the device into the lateral ventricle and manipulating through small ventricles.

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Complete endoscopic removal of colloid cyst using a nitinol basket retriever

Neurosurgical FOCUS ◽

10.3171/2011.1.focus10318 ◽

2011 ◽

Vol 30 (4) ◽

pp. E8 ◽

Cited By ~ 6

Author(s):

Clemens M. Schirmer ◽

Carl B. Heilman

Keyword(s):

Urinary Incontinence ◽

Lateral Ventricle ◽

Memory Loss ◽

Colloid Cyst ◽

Ventricular System ◽

Ventricular Wall ◽

Endoscopic Removal ◽

Flexible Wall ◽

Colloid Cysts ◽

Occipital Horn

Neuroendoscopic treatment of colloid cysts is limited by the reach and flexibility of the instruments that can be passed through the working channels of the rigid neuroendoscope. The authors describe a case of a third ventricular colloid cyst where a large solid colloid fragment was recovered using a nitinol stone retrieval basket as a flexible wall-guided atraumatic salvage instrument. A flexible nitinol stone retrieval basket was successfully used through an endoscopic working channel to retrieve a large portion of the colloid cyst from the occipital horn of the lateral ventricle in a 70-year-old man who presented with progressive memory loss, urinary incontinence, and slowness of gait. A flexible nitinol stone retrieval basket can be safely and effectively maneuvered in the ventricular system, using the ventricular wall for deflection, and can be used to retrieve colloid cyst fragments as a salvage technique. Remaining free-floating large colloid cyst fragments in the ventricular system do not necessarily require a second craniotomy or bur hole for access but may be retrieved using a nitinol stone retrieval basket.

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A solid mass with a cystic component arising in the occipital horn of the lateral ventricle in an elderly women

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2009.05.036 ◽

2010 ◽

Vol 17 (2) ◽

pp. 225

Author(s):

Giuseppe Maria Della Pepa ◽

Riccardo Altavilla ◽

Giovanni Sabatino ◽

Alessio Albanese

Keyword(s):

Lateral Ventricle ◽

Elderly Women ◽

Solid Mass ◽

Cystic Component ◽

Occipital Horn

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Vasopressin enhances the clearance of β-endorphin immunoreactivity from rat cerebrospinal fluid

Acta Endocrinologica ◽

10.1530/acta.0.1220191 ◽

1990 ◽

Vol 122 (2) ◽

pp. 191-200 ◽

Cited By ~ 7

Author(s):

C. G. J. Sweep ◽

Margreet D. Boomkamp ◽

István Barna ◽

A. Willeke Logtenberg ◽

Victor M. Wiegant

Keyword(s):

Cerebrospinal Fluid ◽

Receptor Antagonist ◽

Short Duration ◽

Lateral Ventricle ◽

Underlying Mechanism ◽

Terminal Phase ◽

Intracerebroventricular Injection ◽

Intracerebroventricular Administration ◽

Biphasic Pattern ◽

The Brain

Abstract The effect of intracerebroventricular (lateral ventricle) administration of arginine8-vasopressin (AVP) on the concentration of β-endorphin immunoreactivity in the cerebrospinal fluid obtained from the cisterna magna was studied in rats. A decrease was observed 5 min following injection of 0.9 fmol AVP. No statistically significant changes were found 5 min after intracerebroventricular treatment of rats with 0.09 or 9 fmol. The decrease induced by 0.9 fmol AVP was of short duration and was found 5 min after treatment but not 10 and 20 min. Desglycinamide9-AVP (0.97 fmol), [pGlu4, Cyt6]-AVP-(4–9) (1.44 fmol), Nα-acetyl-AVP (0.88 fmol), lysine8-vasopressin (0.94 fmol) and oxytocin (1 fmol) when intracerebroventricularly injected did not affect the levels of β-endorphin immunoreactivity in the cerebrospinal fluid 5 min later. This suggests that the intact AVP-(1–9) molecule is required for this effect. Intracerebroventricular pretreatment of rats with the vasopressin V1-receptor antagonist d(CH2)5Tyr(Me)AVP (8.63 fmol) completely blocked the effect of AVP (0.9 fmol). In order to investigate further the underlying mechanism, the effect of AVP on the disappearance from the cerebrospinal fluid of exogenously applied β-endorphin was determined. Following intracerebroventricular injection of 1.46 pmol camel β-endorphin-(1–31), the β-endorphin immunoreactivity levels in the cisternal cerebrospinal fluid increased rapidly, and reached peak values at 10 min. The disappearance of β-endorphin immunoreactivity from the cerebrospinal fluid then followed a biphasic pattern with calculated half-lifes of 28 and 131 min for the initial and the terminal phase, respectively. Treatment of rats with AVP (0.9 fmol; icv) during either phase (10, 30, 55 min following intracerebroventricular administration of 1.46 pmol β-endorphin-(1–31)) significantly enhanced the disappearance of β-endorphin immunoreactivity from the cerebrospinal fluid. The data suggest that vasopressin plays a role in the regulation of β-endorphin levels in the cerebrospinal fluid by modulating clearance mechanisms via V1-receptors in the brain.

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