Unilateral Hydrocephalus

1940 ◽  
Vol 86 (363) ◽  
pp. 591-601
Author(s):  
R. M. Stewart
Keyword(s):  
Lateral Ventricle ◽  
Third Ventricle ◽  
Spinal Fluid ◽  
Entire Body ◽  
Foramen Of Monro ◽  
Small Aperture ◽  
Partial Closure ◽  
The Third ◽  
Inflammatory Conditions ◽  
Internal Hydrocephalus

A single small aperture connecting each lateral ventricle with the dorsocephalic portion of the third ventricle provides the sole means of escape for cerebro-spinal fluid, and consequently it follows that any interference with its patency will seriously retard the outward flow of ventricular fluid. Complete, or even partial, closure of the foramen leads to a rapid increase in the volume and pressure of imprisoned ventricular fluid so that a condition of internal hydrocephalus is soon established. Usually both foramina are occluded, the hydrocephalus being therefore bilateral and the ventricles more or less symmetrically enlarged. In rare instances, however, only one foramen is obstructed, in which case the dilatation will, of course, be confined to the ipsilateral ventricle. Unilateral hydrocephalus of this obstructive type is commonly caused by inflammatory conditions in the neighbourhood of the foramen, or by pedunculated tumours attached to the choroid plexus which enjoy a degree of movement sufficient to permit intermittent or permanent blockage of the foramen of Monro. It is, however, possible to find examples of unilateral hydrocephalus in which the outflow of cerebro-spinal fluid through the foramen of Monro is unimpeded, and in these the cause of the ventricular dilatation is to be sought in some diseased condition of the cerebral wall which has become so weakened as to be unable to resist even normal ventricular pressure. Such expansion may be either limited to one part of the lateral ventricle, or general, involving the entire body with its horns.

Choroid plexus cyst and chordoid glioma

2001 ◽  
Vol 10 (6) ◽  
pp. 1-6 ◽  
Author(s):  
Fadi Hanbali ◽  
Gregory N. Fuller ◽  
Norman E. Leeds ◽  
Raymond Sawaya
Keyword(s):  
Choroid Plexus ◽  
Lateral Ventricle ◽  
Short Term Memory ◽  
Third Ventricle ◽  
Cancer Center ◽  
Foramen Of Monro ◽  
The Third ◽  
Chordoid Glioma ◽  
Choroid Plexus Cyst

Several types of mass lesions may occur in the third and lateral ventricles. Typically they arise from the lining of the ventricular cavity or from contiguous structures, by extension into the ventricle. The authors describe two patients, each of whom presented with a different rare lesion of the ventricular system. The first was a 53-year-old woman with a history of hypertension who sustained a blunt traumatic injury to the occipital region and subsequently developed a progressively worsening right-sided headache. Radiological examinations over the next 2 years revealed an enlarged right lateral ventricle and, ultimately, a choroid plexus cyst in its anterior and middle third, near the foramen of Monro, which is a rare location for these lesions. The cyst was removed en bloc, and follow-up examinations showed a significant improvement in her headache and a minimal differences in size between right and left ventricles. The authors also describe a 57-year-old man with hypertension, diabetes mellitus, and an old mycardial infarct, who presented to an outside institution with a progressively worsening headache, generalized malaise, and loss of olfactory sensation. Diagnostic imaging revealed a 1.5-cm oval lesion centered in the lamina terminalis region, an open craniotomy was performed, and evaluation of a biopsy sample demonstrated the mass to be a chordoid glioma of the third ventricle, a recently described glioma subtype. Two days after surgery, he suffered a left parietal stroke and an anterior mycardial infarction. After convalescing, he presented to The University of Texas M. D. Anderson Cancer Center for radiotherapy and follow up; 7 months later he was readmitted complaining of headache, short-term memory loss, and worsening confusion and disorientation. Neuroimaging revealed progression of the tumor (now 2 cm in diameter), which was removed by gross-total resection. His headache resolved immediately, and 2 months later his only complaint was of episodes of confusion. Three weeks later he died of a massive myocardial infarction. These two patients represent the sixth case of an adult with a choroid plexus cyst in the anterior lateral ventricle and the 19th case of an adult with a chordoid glioma of the third ventricle, respectively.

scholarly journals Endoscopic colloid cyst resection by puncture of the medial wall of lateral ventricle, posterior to the foramen of Monro

2012 ◽  
Vol 19 (1) ◽  
pp. 15-22
Author(s):  
D. Păunescu ◽  
M. Gorgan ◽  
Ligia Tătăranu
Keyword(s):  
Endoscopic Resection ◽  
Lateral Ventricle ◽  
Therapeutic Strategy ◽  
Third Ventricle ◽  
Colloid Cyst ◽  
Benign Lesions ◽  
Foramen Of Monro ◽  
Non Invasive ◽  
The Third ◽  
Optimal Therapeutic Strategy

Abstract No consensus among neurosurgeons has been reached so far concerning optimal therapeutic strategy for colloids cysts, especially as these are non-invasive,slowgrowing, benign lesions. In symptomatic cases, endoscopic resection can be achieved as first intention when it seems to have a cyst containing fluid and there is ventriculomegaly. Cyst location and degree of superior distension of the third ventricle roof, associated with the emergence of Monro’s foramen can cause problems when using a rigid endoscope, the visualisation being impossible or difficult. Posterior interventricular foramen puncture may be helpful in such cases.

Multiple Colloid Cysts: Case Report and Literature Review

2018 ◽  
Vol 79 (06) ◽  
pp. 536-540
Author(s):  
Martin Bettag ◽  
Ahmed Rizk
Keyword(s):  
Lateral Ventricle ◽  
Third Ventricle ◽  
Complete Removal ◽  
Ventricular Catheter ◽  
Foramen Of Monro ◽  
The Third ◽  
Colloid Cysts ◽  
Magnetic Resonance Imaging Mri ◽  
Clinical Description ◽  
The Right

Background and Study Aim Colloid cysts usually occur in the anterior third ventricle at the level of the foramina of Monro. Colloid cysts may extend from the third toward the lateral ventricle. We present a rare case of multiple intraventricular colloid cysts, two of which were in the third ventricle and one in the lateral ventricle. Clinical Description A 40-year-old female patient presented with three intraventricular cystic lesions: one cyst in the typical localization in the anterior rostral third ventricle, another cyst behind it in the same (third) ventricle, and a larger bulging cyst in the right lateral ventricle. A bilateral ventriculoperitoneal shunt had been inserted 26 years before to treat hydrocephalus. All three cysts had different magnetic resonance imaging (MRI) signal characteristics. We removed the cysts through an endoscopically assisted right transcortical transventricular microsurgical approach, using the right ventricular catheter as a guide to the lateral ventricle. After removal of the lateral ventricular cyst, we observed that the foramen of Monro was greatly enlarged (most likely as a result of the large cyst), which allowed us to remove the cysts in the third ventricle. During surgery, the cysts were found to have different consistencies. MRI 2 years following surgery showed complete removal and no hydrocephalus. The patient had no symptoms, and the clinical examinations were normal. Conclusions Colloid cysts may become large and extend to the lateral ventricle, especially in patients treated with ventriculoperitoneal shunts. Studying the relevant pathoanatomy of these cysts is very important for preoperative planning including the choice of surgical approach.

Limitations of the transcallosal transchoroidal approach to the third ventricle

2009 ◽  
Vol 111 (3) ◽  
pp. 600-609 ◽  
Author(s):  
Arthur J. Ulm ◽  
Antonino Russo ◽  
Erminia Albanese ◽  
Necmettin Tanriover ◽  
Carolina Martins ◽  
...  
Keyword(s):  
Parietal Cortex ◽  
Lateral Ventricle ◽  
Third Ventricle ◽  
Limiting Factors ◽  
Posterior Angle ◽  
Foramen Of Monro ◽  
Mammillary Bodies ◽  
The Third ◽  
Anterior Angle ◽  
Formalin Fixed

Object The aim of this study was to determine the anatomical limitations of the transcallosal transchoroidal approach to the third ventricle. Methods Twenty-six formalin-fixed specimens were studied. Sagittal dissections were used to determine the anatomical relationships of the foramen of Monro, the angle of approach to landmarks, and placement of a callosotomy. Lateral ventricular dissections were performed to quantitate the forniceal anatomy. Results The foramen of Monro was found 1.07 ± 0.11 cm superior and slightly anterior to the mammillary bodies, 1.48 ± 0.16 cm posterosuperior to the optic recess, and 2.26 ± 0.16 cm anterosuperior to the aqueduct. Relative to the genu, a callosal incision 2.64 ± 0.53 cm long and angled 37 ± 4.3° anterior was needed to access the aqueduct, and an incision 4.92 ± 0.71 cm long and angled 49 ± 7.4° posterior was needed to access the optic recess. The fornix progressively widened within the lateral ventricle, from 1.25 ± 0.63 mm at the foramen of Monro to > 7 mm at 2 cm behind the foramen. Three zones of exposure were identified, requiring unique craniotomies, callosotomies, and angles of approach. The major limiting factors in the approach included the columns of the fornix anteriorly, the width of the fornix posteriorly, and the draining veins of the parietal cortex. The choroidal fissure opening was limited to 1.5 cm posterior to the foramen of Monro; this limited opening created an aperture effect that required an anterior-to-posterior angle, an anterior craniotomy, and an anteriorly placed callosotomy to access the posterior landmarks. In contrast, a posterior-to-anterior angle, posteriorly placed craniotomy, and posteriorly placed callosotomy were required to access anterior landmarks. Conclusions The transcallosal transchoroidal approach was ideally suited to access the foramen of Monro and the middle and posterior thirds of the third ventricle. Exposure of the anterior third ventricle was limited by the columns of the fornix and by the presence of parietal cortical draining veins.

Lateral Ventricle Choroid Plexus Papilloma Extending into the Third Ventricle

2004 ◽  
Vol 40 (6) ◽  
pp. 314-316 ◽  
Author(s):  
Federico Di Rocco ◽  
Massimo Caldarelli ◽  
Giovanni Sabatino ◽  
Gianpiero Tamburrini ◽  
Concezio Di Rocco
Keyword(s):  
Choroid Plexus ◽  
Lateral Ventricle ◽  
Third Ventricle ◽  
Choroid Plexus Papilloma ◽  
The Third ◽  
Plexus Papilloma

Purely Endoscopic Resection of Colloid Cysts

2008 ◽  
Vol 62 (suppl_1) ◽  
pp. ONS51-ONS56 ◽  
Author(s):  
Jeremy D.W. Greenlee ◽  
Charles Teo ◽  
Ali Ghahreman ◽  
Bernard Kwok
Keyword(s):  
Endoscopic Resection ◽  
Third Ventricle ◽  
Colloid Cyst ◽  
Foramen Of Monro ◽  
The Third ◽  
Colloid Cysts ◽  
Study Support

Abstract Objective: To further assess the safety and long-term efficacy of endoscopic resection of colloid cysts of the third ventricle. Methods: A retrospective review of a series of 35 consecutive patients (18 male, 17 female) with colloid cysts treated by endoscopic surgery was undertaken. Results: The mean patient age was 32.4 years (range, 11–54 yr). Headache was the most common presenting symptom (22 patients). The average tumor size was 18 mm (range, 3–50 mm). The endoscopic technique could not be completed in six patients, necessitating conversion to an open craniotomy and a transcortical approach to the colloid cyst. All patients had histologically confirmed colloid cysts of the third ventricle, and complete resection of the lesion was confirmed macroscopically and radiologically in all patients. There were no deaths. Two patients developed aseptic meningitis without any permanent sequelae. One patient developed unilateral hydrocephalus attributable to obstruction of the foramen of Monro, which was treated with endoscopic septum pellucidotomy. The median follow-up period was 88 months (range, 10–132 mo). There was one asymptomatic radiological recurrence. No seizures occurred after surgery. Conclusion: The results of this study support the role of endoscopic resection in the treatment of patients with colloid cysts as a safe and effective modality. In some cases, conversion to an open procedure may be required. Additional follow-up will be required to continue to address the duration of lesion-free survival.

Endoscopic Fenestration of Cavum Septum Pellucidum Cysts to the Third Ventricle: Technical Note

2020 ◽  
Vol 19 (4) ◽  
pp. E434-E439
Author(s):  
Alexandre Simonin ◽  
Omar Bangash ◽  
Arjun S Chandran ◽  
Erik Uvelius ◽  
Christopher Lind
Keyword(s):  
Surgical Procedure ◽  
Clinical Presentation ◽  
Third Ventricle ◽  
Technical Note ◽  
Septum Pellucidum ◽  
Imaging Studies ◽  
Foramen Of Monro ◽  
Cavum Septum Pellucidum ◽  
The Third ◽  
Endoscopic Fenestration

Abstract BACKGROUND AND IMPORTANCE Cavum septum pellucidum (CSP) and cavum vergae (CV) cysts are common incidental findings on imaging studies. However, they may rarely present with symptoms related to the obstruction of the foramen of Monro by the cyst leaflets. There is no consensus regarding the management of symptomatic CSP and CV cysts. We present an original transcavum interforniceal endoscopic fenestration technique. The step-by-step surgical procedure and two illustrative cases are presented. CLINICAL PRESENTATION A 31-yr-old male and a 24-yr-old woman presented with symptomatic CSP and CV cysts. For both patients, neuronavigation was used to plan the procedure. An endoscope was introduced into the cyst through a right frontal burr-hole. After an examination of the endoscopic anatomy, a communication between the cyst and the third ventricle was performed using an endoscopic forceps. In both cases, directly after the fenestration, cerebrospinal fluid (CSF) passed through the communication, and the collapse of the cyst was appreciated. Symptoms were relieved in both patients, and neuropsychological assessment improved. Postoperative imaging showed a reduction in the cyst bulge, and patent foramen of Monro. CONCLUSION Endoscopic fenestration of CSP and CV cysts to the third ventricle through an interforniceal navigated approach is a feasible and efficient surgical procedure. Theoretical advantages include a single tract through noneloquent brain, a perpendicular trajectory to the membrane for fenestration, and a large CSF space beyond the fenestration point.

Sign in / Sign up

Export Citation Format

Share Document