Endosonographic anatomy of the ventricular system

A preclinical cadaver study was performed to test a transendoscopic sonographic probe for neurosurgery. In 25 fresh post-mortem adult human cadaver with a total of 39 endo-sonographic dissections in the ventricular system were carried out. A sonograph with an outer diameter of 6 F was used and radial sonograms were made by a real-time image technique. First results showed precise imaging, comparable to a CT in a neighbouring area of 3 cm. In this publication, the authors describe the endo-neurosonographic anatomy of the ventricular system. The sonographic probe was advanced through the working canal of a ventriculoscope, then the endoscopic and sonographic imaging were compared. Results were documented by parallel sonographic and endoscopic photo and video recordings. Based on the authors experience, it is revealed that the additional sonographic view could also be used as a navigation tool.     

显微手术治疗侧脑室肿瘤

目的 总结32例侧脑室肿瘤的主要临床表现，手术入路和治疗效果，以提高侧脑室肿瘤的全切率，减少并发症，改善手术效果。方法 回顾性分析一组32例侧脑室肿瘤，CT、MRI作为术前诊断及设计手术入路的主要依据。本组按肿瘤叶中心部位不同分别采用经皮质入路和经胼胝体入路，运用显微外科手术切除肿瘤。结果 手术全切肿瘤26例，次全切除肿瘤4例，大部切除肿瘤2例，无手术死亡。结论 选择合适的手术入路，合理运用显微手术技术切除侧脑室肿瘤．可获得良好的手术效果。     

鼻腔神经组织肿瘤临床病理与预后

３１例鼻腔神经组织肿瘤临床与病理分析表明：该类肿瘤是鼻腔内比较少见的肿瘤，可见于各年龄组。病理分类：嗅神经母细胞瘤１８例，黑色素瘤１例，脑膜瘤６例，胶质瘤４例，神经鞘瘤２例。良性肿瘤需手术切除，预后良好，恶性肿瘤不需要手术彻底且术后加用放射治疗。对１３例恶性肿瘤进行随访，其１年生存率（１２／１３）为９２．３％，３年生存率（７／１３）为３２．８％，５年生存率（３／１３）为２３．０８％。结合临床表现分     

Magnetic resonance imaging of fourth ventricular epidermoid tumors

Two pathologically proved cases of epidermoid tumor of the fourth ventricle are presented; clinical history and computed tomographic, magnetic resonance imaging, and histopathologic findings are included.     

Endoscopic options in management of posterior third ventricular tumors

Objective A spectrum of both radiosensitive and radio-resistant lesions occurs in the region of the posterior third ventricle (PTV). Most of these are associated with hydrocephalus requiring a cerebrospinal fluid diversion procedure. The present study aims to assess the effectiveness of endoscopic biopsy and third ventriculostomy (ETV) in these patients. Materials and methods Twenty-four patients with PTV lesions with moderate to severe hydrocephalus were managed prospectively. All patients underwent ETV and biopsy of the lesion during the same procedure. The ETV could be performed in all patients, where as in 23, a successful biopsy could be obtained. The ETV was successful in 22 patients; it failed in 2 patients requiring shunt insertion. A positive biopsy was obtained in all the patients (pinealocytoma 4, pinealoblastoma 10, embryonal cell carcinoma 1, germinoma 2, oligodendroglioma 1, astrocytoma 2, tuberculoma 4). All patients were subsequently managed with further surgery, radiation, and chemotherapy either alone or in combination depending on the pathology. One patient with a tumor bed hematoma required clot evacuation. The follow-up period ranged from 12 to 36 months. Two patients died, one during hospital stay with a tumor bed hematoma and another at 6 months follow-up due to extensive leptomeningeal spread. Conclusions The high yield of endoscopic biopsy (100%) and success of ETV (91%) emphasizes its role in management of the diverse group of PTV lesions in arriving at the optimal definitive management.     

经鼻蝶入路神经内镜手术治疗斜坡区肿瘤的应用解剖

目的 探讨经鼻蝶入路神经内镜手术治疗斜坡区肿瘤的应用解剖特征。方法 利用10具（20侧）成人尸头标本,模拟经鼻蝶入路神经内镜手术,从颅底内、外两面观察,测量斜坡及相关毗邻骨性结构。结果 ①斜坡外表面呈凸状向下倾斜,长度为28.12 mm,由外展神经硬膜孔和舌咽神经水平将斜坡分为上、中、下三段:舌下神经管外口到颈静脉结节距离,左侧（5.80±0.82）mm,右侧（5.91±0.79）mm;到枕骨大孔前缘中点距离,左侧（19.54±1.72）mm,右侧（18.42±1.69）mm;到中线距离,左侧（17.08±2.25）mm;咽结节到枕骨大孔前缘中点距离（12.12±1.63）mm;斜坡可切除面积（805.92±5.24）mm2,枕髁可切除面积（144.47±4.76）mm2。②斜坡内面观,斜坡由枕骨大孔向前上方宽而浅的倾斜而成,两侧以岩斜裂与岩骨相毗邻:舌下神经管内口到枕骨大孔前缘,左侧（15.12±1.59）mm,右侧（14.25±1.63）mm;到枕髁前缘距离,左侧（12.77±1.47）mm,右侧（11.16±1.44）mm。结论 熟悉斜坡的重要解剖标记对经鼻蝶入路神经内镜手术中切除范围有重要指导作用。     

Pathological and clinical features of primary ventricular hemorrhage due to moyamoya disease]

The clinical and pathological features of 20 cases of moyamoya disease complicated with primary intraventricular hemorrhage (PIVH) and verified by CT scanning, cerebral angiography and autopsy were reported. It seemed to the author that moyamoya disease appeared to be prone to cause PIVH, this hemorrhage being likely due to ischemic malacia in the ventricular wall. The tortuous, abnormal network vessels ruptured and bled as a result of infarction and damage of the walls of the miliary aneurysms. PIVH might be divided into two types: the panventricular hemorrhage and partial ventricular hemorrhage, according to the amount of blood that filled into the ventricles. 6 cases of the panventricular type were fatal. The symptoms were in conformity with the traditional concept of the most critical, intraventricular hemorrhage. The external ventricular drainage in combination with lumber puncture drainage would be the better way of treatment for these patients. 14 cases of the partial ventricular hemorrhage type showed the clinical features of acute subarachnoid hemorrhage (SAH). The treatment was similar to SAH too, and the prognosis was much better. It would be worth noting that moyamoya disease should be a factor not to be neglected in causing PIVH.