This study was carried out on 36 patients (the youngest was 2 years old and the oldest was 64 years old) with tumors located in the 4th ventricle, which were admitted to Cho Ray Hospital in 2002. Results: meduloblastomas was the most common tumors (58.3%), following ependymomas (19.4%) and astrocytomas (11.1%). Some type of tumors were rare: hemangioblastomas (5.6%), meningioma (2.8%), and lymphoma (2.8%). The median duration of symptoms from the onset to diagnosis was 8 weeks. Most of patients experienced intra-cranial hypertension syndrome (97.2%), and cerebellar syndrome (77.8%). On the brain CT scan images, the different characteristics of tumors including calcifications, hemorrhage, cyst-necrosis, density and contrast enhancements were useful in making differential diagnosis. The rate of lateral and the 3rd ventricular dilatations were very high (94.4%) because tumors quickly blocked flow of cerebrospinal fluid
Fourth Ventricle ; Cerebral Ventricle Neoplasms ; Microscopy, Electron, Scanning ; diagnosis ; neoplasms

No abstract available.
Central Nervous System Neoplasms ; Cerebral Ventricle Neoplasms ; Lymphoma*

Study on 73 fourth ventricle tumors that were operated at Cho Ray hospital, from May 2000 to October 2003. The results: tumors were seen in both children and adults, in male more than female at the ages ranging from 2 years old to 64 years old. The most common age group were 1-10 years (52%), then 11-20 years old (21.9%). In fourth ventricle tumors, the median duration of symptoms prior to radiological diagnosis was 6 weeks. The patients experienced symptoms such as headache, vomitting, vertigo. The common syndromes were: raised intracranial pressure syndrome, cerebellar syndrome, pyramidal syndrome and epilepsy. Brain CT scan, absence of cysts and calcifications, homogeneous hyperdensity favor the diagnosis of medulloblastoma. Ependymomas were typically nonhomogeneous hyperdensity, calcified. Astrocytomas showed nonhomogenous hyperdensity and minimal calcification. Most of cases had ventricular dilatation
Cerebral Ventricle Neoplasms ; diagnosis ; Tomography Scanners, X-Ray Computed

Choroid plexus papilloma(CPP) is a rare intraventricular neoplasm occurring primarily in the lateral ventricle of children and the 4th ventricle of adults. The 3rd ventricle is an extremely rare site for CPP to occur. The authors report two cases of CPP of the 3rd ventricle in a 2-month-old girl and a 4-month-old boy, and one case of CPP of the 4th ventricle in a 17-year-old male. Two CPP of third ventricle were totally removed by transcortical-transventricular approach and transcallosal subchoroidal approach, respectively. The CPP in the fourth ventricle was totally removed by suboccipital approach. The subdural hygroma and hydrocephalus due to CSF overproduction was managed with subduroperitoneal shunt and ventriculoperitoneal shunt.
Adolescent ; Adult ; Cerebral Ventricle Neoplasms ; Child ; Choroid Plexus* ; Choroid* ; Female ; Fourth Ventricle* ; Humans ; Hydrocephalus ; Infant ; Lateral Ventricles ; Male ; Papilloma, Choroid Plexus* ; Subdural Effusion ; Third Ventricle ; Ventriculoperitoneal Shunt

Chordoid glioma is a rare low grade tumor typically located in the third ventricle. Although a chordoid glioma can arise from ventricle with tumor cells having features of ependymal differentiation, intraventricular dissemination has not been reported. Here we report a case of a patient with third ventricular chordoid glioma and intraventricular dissemination in the lateral and fourth ventricles. We described the perfusion MR imaging features of our case different from a previous report.
Adult ; Cerebral Ventricle Neoplasms/diagnosis/pathology/*secondary ; Fourth Ventricle/*pathology ; Glioma/diagnosis/*pathology ; Humans ; Lateral Ventricles/*pathology ; Magnetic Resonance Imaging/methods ; Male ; Third Ventricle/*pathology

The authors report a case of 42-year-old woman with an intraventricular tumor in the trigone of the left lateral ventricle. The first operation achieved a microscopically complete resection. The tumor was histologically atypical meningioma. After 26 months, there were recurrences of intraventricular meningioma. Complete resection of the tumor and adjuvant radiation therapy were performed, and the histological diagnosis was malignant meningioma. Sixteen months after the second operation, spinal metastasis in cervicolumbar lesion was diagnosed and a subtotal removal of cervical intradural extramedullary mass was performed. We describe an unusual case of intraventricular malignant meningioma with cerebrospinal fluid-disseminated spinal metastases with review of the clinical courses of previous reports.
Adult ; Cerebral Ventricle Neoplasms ; Female ; Humans ; Lateral Ventricles ; Meningioma ; Neoplasm Metastasis ; Recurrence

Adult ; Cerebral Ventricle Neoplasms ; diagnosis ; Female ; Glioma ; diagnosis ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Visual Fields

Adult ; Biopsy ; Cerebral Ventricle Neoplasms ; diagnosis ; Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Neoplasms, Neuroepithelial ; diagnosis ; Third Ventricle ; diagnostic imaging

BACKGROUNDIn recent years, keyhole microsurgery has become an important subject of modern minimally invasive neurosurgery. In this study, minimally invasive techniques avoiding unnecessary tissue injuries were applied to refine traditional approaches for the removal of third ventricular tumors within a limited operative filed.

METHODSIndividualized keyhole approaches were designed according to the characteristics of third ventricular tumors and their growth patterns. A series of keyhole approaches such as supraorbital subfrontal approach, infratentorial supracerebellar approach, interhemispheric transcallosal approach, pterional approach were taken to enter the third ventricle anteriorly, posteriorly, superiorly or laterally, respectively. A total of 34 removed tumors in or extended into the third ventricle included 11 craniopharyngiomas, 10 pituitary adenomas, 2 pinealomas, 1 cholesteatoma, 3 germinomas, and 7 gliomas.

RESULTSTotal tumor resection was done in 27 (79.4%) of the patients, and subtotal resection in 7 patients (20.6%). Residual tumor was due to tight adherence of germinoma to the vein of Galen (1 patient), craniopharyngioma to the pituitary stalk (3), supratentorial extension of pineal region gliomas (1), suprasellar extension of gliomas (1) and giant pituitary adenoma (1). Complications such as brain contusion, postoperative hemorrhage and infection were not associated with keyhole approaches. Extended incision or enlarged bone flap was not made because of episode during operation or inadequate exposure.

CONCLUSIONSKeyhole approaches are safe, effective and minimally invasive in the surgical treatment of tumors deeply seated in the third ventricle. Individualized keyhole approach ensures a successful treatment. Tumors in the upper middle part of the third ventricle can be exposed by the interhemispheric transcallosal keyhole approach. Tumors of the posterior third ventricle may be well exposed by the infratentorial supracerebellar keyhole approach. Tumors of the anterior third ventricle can be entered by either a supraorbital subfrontal keyhole approach or a pterional keyhole approach.

Adolescent ; Adult ; Cerebral Ventricle Neoplasms ; surgery ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Neurosurgical Procedures ; methods ; Third Ventricle ; surgery

Subependymoma is a rare, slow-growing, benign noninvasive tumor of the central nervous system that may be located in the fourth ventricle, the septum pellucidum, the third and the lateral ventricles, the aqueduct, and the proximal spinal cord. Symptoms, if any, usually result either from direct compression of the brain stem or from acute hydrocephalus due to occlusion of the foramen of Monro or aqueduct of Sylvius. In this report, we describe a case of subependymoma of the lateral ventricle with headache in a young female patient. This is the first reported case subependymoma in Korea that was documented along with Magnetic resonance image.
Adult ; Cerebral Ventricle Neoplasms/*diagnosis/pathology ; Female ; Glioma/*drug therapy/pathology ; Headache/complications ; Humans ; Magnetic Resonance Imaging