Suprasellar cistern lipoma - tuber cinereum

The Endoscopic Endonasal Transtubercular Route to the Suprasellar Cistern: Surgical Nuances and Rationale for Periinfundibular Tumors

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0034-1384061 ◽

2014 ◽

Vol 75 (S 02) ◽

Author(s):

Berhouma Moncef ◽

T. Jacquesson ◽

C. Garnieri ◽

V. Delabar ◽

E. Jouanneau

Keyword(s):

Endoscopic Endonasal ◽

Suprasellar Cistern

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Metrizamide Computed Tomographic Cisternography for the Diagnosis of Occult Lesions of the Hypothalamic-Hypophyseal Axis in Children

Neurosurgery ◽

10.1227/00006123-198105000-00004 ◽

1981 ◽

Vol 8 (5) ◽

pp. 531-541 ◽

Cited By ~ 5

Author(s):

Dachling Pang ◽

Arthur E. Rosenbaum ◽

James E. Wilberger ◽

James P. Gutai

Keyword(s):

Computed Tomography ◽

Diagnostic Yield ◽

Empty Sella ◽

Functional Disorders ◽

Ct Cisternography ◽

Empty Sella Syndrome ◽

Computed Tomographic ◽

Suprasellar Cistern ◽

Enhanced Computed Tomography ◽

Metrizamide Ct Cisternography

Abstract In children, hypothalamic-hypophyseal syndromes such as diabetes insipidus, precocious puberty, growth retardation, and panhypopituitarism can be due either to structural lesions or to functional disorders of the cerebral endocrine complex. When clinical and endocrinological parameters fail to distinguish between these etiologies, neuroradiographical diagnosis becomes extremely important. Although conventional intravenously enhanced computed tomography (IVCT) is satisfactory for the diagnosis of lesions larger than 1 cm, metrizamide CT cisternography (MCTC) greatly improves the diagnostic yield for smaller juxtapituitary masses in the suprasellar cistern, clearly defines their sizes and relationships with contiguous structures, and definitively confirms the diagnosis of empty sella syndrome. Six patients with endocrinopathies and normal or ambiguous IVCT findings are presented to illustrate how MCTC can influence their management and outcome without the patient discomfort and technical complexity associated with pneumoencephalography.

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PERFORATED DUODENAL ULCER AND NEOPLASM OF THE TUBER CINEREUM IN THE NEWBORN

Journal of Neuropathology & Experimental Neurology ◽

10.1097/00005072-194710000-00007 ◽

1947 ◽

Vol 6 (4) ◽

pp. 391-400 ◽

Cited By ~ 9

Author(s):

JOSEPH I. MOSSBERGER

Keyword(s):

Duodenal Ulcer ◽

Perforated Duodenal Ulcer ◽

Tuber Cinereum

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Lateral Ventricle to Sylvian Fissure Shunt for Obstructive Hydrocephalus: First Report

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0037-1600516 ◽

2017 ◽

Vol 78 (05) ◽

pp. 513-516

Author(s):

Sushil Patkar

Keyword(s):

Lateral Ventricle ◽

Fourth Ventricle ◽

Superior Sagittal Sinus ◽

Obstructive Hydrocephalus ◽

Shunt Operation ◽

Ventriculoatrial Shunt ◽

Sagittal Sinus ◽

Suprasellar Cistern ◽

Sylvian Cistern

AbstractCerebrospinal fluid (CSF) pathway studies have revealed that the CSF secreted from the choroid plexus of the ventricles after egressing from the fourth ventricle reaches the basal suprasellar cistern and ultimately the sylvian cisterns. From the sylvian cistern, the CSF travels over the cerebral convexity subarachnoid space to reach the superior sagittal sinus and enters the bloodstream. Diverting CSF from the lateral ventricle with a shunt catheter to the sylvian cistern can be an option to treat obstructive hydrocephalus. An adult patient with posttraumatic hydrocephalus with contraindications to ventriculoperitoneal and ventriculoatrial shunt placement underwent this procedure of diverting CSF from the lateral ventricle to the sylvian cistern successfully, and he had immediate relief of symptoms of raised intracranial pressure. Although preliminary results seem logical and promising, more cases and longer follow-up is required to consider this shunt operation an option in the treatment of obstructive hydrocephalus.

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Intraventricular Craniopharyngiomas—Overcoming Their Relative Inaccessibility: Institutional Experience With a Review of Literature

Frontiers in Neurology ◽

10.3389/fneur.2021.755784 ◽

2021 ◽

Vol 12 ◽

Author(s):

Chandrashekhar Deopujari ◽

Sanjay Behari ◽

Krishna Shroff ◽

Ashutosh Kumar ◽

Bhushan Thombre ◽

...

Keyword(s):

Tertiary Care ◽

Term Outcome ◽

Complete Excision ◽

Long Term Outcome ◽

Ifn Alpha ◽

Cystic Tumors ◽

Institutional Experience ◽

Radiotherapy Alone ◽

Suprasellar Cistern ◽

Surgical Field

Introduction: Craniopharyngiomas constitute 2–4% of intracranial neoplasms. Intraventricular craniopharyngiomas (IVCrs) are the rarely encountered varieties of these lesions.Objective: The objective of the study was to study the special features in clinical presentation, imaging, management, and surgical outcome of IVCrs.Materials and Methods: This retrospective analysis included the combined experience from two tertiary care institutions. Medical records of histopathologically proven cases of IVCrs from January 1994 to June 2021 were assessed, and images were analyzed based on the criteria by Migliore et al. for inclusion of solely intraventricular lesion with the third ventricular ependyma demarcating it from the suprasellar cistern.Results: Among the 25 patients included (mean age: 35.4 years), the most common presentation included headache (n = 21, 84%), vomiting and other features of raised ICP (n = 18, 72%), visual complaints (n = 12, 48%), and endocrinopathies (n = 11, 44%). Fifteen had predominantly cystic tumors, two were purely solid, and eight were of mixed consistency. Primary open microsurgical procedures were performed in 18 (72%) patients, of which four (16%) were endoscope-assisted. Seven (28%) underwent a purely endoscopic procedure. One underwent a staged surgery with endoscopic cyst fenestration and intracystic interferon (IFN)-alpha therapy, followed by microsurgical excision. Complete excision was achieved in 10 patients, near-total in nine, and partial excision in six. Four patients underwent a ventriculoperitoneal shunt (one before the definitive procedure). At a median follow-up of 36 months (range:11–147 months), five patients developed a recurrence, and one had a stable small residue. This patient and two others with small cystic recurrences were observed. One patient was managed with radiotherapy alone. Another underwent re-surgery after a trial of radiotherapy, and the last patient developed a local recurrence, which was managed with radiotherapy; he then later developed an intraparenchymal recurrence, which was operated.Conclusion: Purely IVCrs present with raised intracranial pressure, and visual disturbances are less common. Their deep-seated location and limited surgical field-of-view makes minimally invasive endoscopic-assisted surgery most suitable for their excision. The thin-walled cystic lesions may be occasionally adherent to the ependymal wall in close vicinity to the thalamus–hypothalamus complex, making complete excision difficult. Their responsiveness to radiotherapy, often leads to a gratifying long-term outcome.

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