Etiological differences between the isolated lateral ventricle and the isolated fourth ventricle

Objective To determine if an etiological difference exists between isolation of the lateral ventricle and isolation of the fourth ventricle after ventricular shunting.Methods Cases of symptomatic isolation of the lateral and fourth ventricles were reviewed retrospectively. The ages at presentation of ventricular isolation, the time course to development of isolation, the number of shunt surgeries leading up to symptomatic isolation, the types of shunt valves utilized, and the background of infection were analyzed.Results Twenty-six patients had lateral ventricle isolation and 11 patients had fourth ventricle isolation. Infection, hemorrhage, Chiari malformation/myelomeningocele, and aqueductal stenosis were factors contributing to hydrocephalus requiring treatment in these patients. Compared to 26.9% of patients with lateral ventricle isolation, 90.9% of patients with fourth ventricle isolation had a previous history of infection.Conclusions Prior meningitis and ventriculitis frequently contributed to fourth ventricle isolation. Lateral ventricle isolation seems to arise from functional obstruction of the foramen of Monro related to prior shunting.     

Persistent olfactory bulb ventricle

A large cystic olfactory bulb was discovered incidentally at autopsy. There was no evidence of central nervous system trauma or infection. Hemispheric malformations did not exist except for a dorsal displacement of the overlying gyrus rectus. We interpreted the cyst to be a persistent olfactory bulb ventricle.     

Intrinsic III ventricle craniopharyngioma

A case of intrinsic III ventricle craniopharyngioma in an 11-year-old girl is presented. Only five cases in children have previously been reported in detail. The intraventricular location of a craniopharyngioma originates from ectopic remnants and causes intracranial hypertension without hormonal or neurological disorders. the tumor was safely removed by the transcallosal approach, and we confirmed that the floor of the III ventricle was intact.     

第四脑室肿瘤显微手术治疗

我院自1995年1月至2005年4月显微手术治疗第四脑室肿瘤12例，取得了较好的效果。现将有关临床资料总结如下.     

Fourth ventricle arachnoid cyst.

We report four patients with fourth ventricle arachnoid cysts. There were two males and two females and the ages ranged from 18 months to 52 years (average 21 years). All patients presented with symptoms of raised intracranial pressure. Excision or marsupialization of the arachnoid cyst in this location was curative in all patients. The follow-up ranged from 1 to 14 years.     

Brain swelling and ventricle size

Cerebral ventricle size was measured in one hundred normal people, age 10 to 50 years. The measurements were obtained from computed tomographic (CT) scan examinations, using the Huckman (1975) method. Normal ventricles were significantly bigger at age 45 than at age 15. These normals were compared to groups of patients with pseudotumor cerebri, water intoxication and cerebral edema, and cerebral hypoxia and edema due to cardio-respiratory arrest. The relative ventricular size was the same in the normal group and all three disease groups. Measurement of ventricle size from CT scan images is not even a crude index of cerebral edema in these three diseases.     

Meningioma of the third ventricle

A case of meningioma of the third ventricle is described. The tumor was completely removed using a transcallosal approach.     

Hemangioblastoma of the IV ventricle

A case of solid hemangioblastoma in the IV ventricle in a 16-year-old boy is reported because of the rarity of this type of lesion. Microsurgical removal of the lesion was accomplished without any side effects in this highly vascular tumor in a strategic location.     

Third ventricle choroid plexus papillomas

Choroid plexus papillomas are only infrequently located in the third ventricle. Two infants with such lesions are presented and the diagnosis by computed tomography described. The transcallosal approach to the third ventricle was employed in both cases and led to successful excision. This approach is recommended for lesions in the anterior third ventricle in children, and the occurrence of subdural effusions as a complication is pointed out.