1/12. Presumed intraventricular meningioma treated by embolisation and the gamma knife.A 58-year-old woman with a presumed incidentally discovered meningioma in the left lateral ventricle was treated by superselective embolisation and gamma knife therapy. The diameter of the tumour was 40 mm, and its main feeding artery was the left lateral posterior choroidal artery. This vessel was embolised with microcoils. At 8 months following embolisation, the diameter of the tumour had decreased and was stable. The gamma knife was chosen as an adjuvant therapy for the further control 13 months after embolisation. Embolisation and gamma knife therapy may be an alternative treatment for meningiomas where surgical resection appears difficult.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/12. Relationships of virtual reality neuroendoscopic simulations to actual imaging.Advances in computer technology have permitted virtual reality images of the ventricular system. To determine the relevance of these images we have compared virtual reality simulations of the ventricular system with endoscopic findings in three patients. The virtual fly-through can be simulated after definition of waypoints. Flight objects of interest can be viewed from all sides. Important drawbacks are that filigree structures may be missed and blood vessels cannot be distinguished clearly. However, virtual endoscopy can presently be used as a planning tool or for training and has future potential for neurosurgery.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/12. meningioma of the lateral cerebral ventricle. A case report.The authors present the case of a 58-year-old woman. At presentation the patient complained of vertigo and noise in the ears with six months history, and from headache, accompanied by nausea and vomiting from three months. The physical examination of the patient found no abnormalities. The neurological examination revealed discoordination syndrome and mild hemiparesis of the left limbs. Computed tomography of the brain without and with contrast medium showed oval tumor, localized in the region of trigonum collaterale and the posterior horn of the right lateral ventricle. Operative intervention was performed after a preoperative management of the patient: transcortical fenestration of the brain in the region of trigonum collaterale and the posterior horn of the right lateral ventricle. The tumor was totally removed. It is well isolated, oval in shape, with feeding blood vessel from plexus chorioideus and was attached to the wall of the ventricle with several thin bridges. Macroscopically the tumor was 3 cm in diameter, with smooth walls, well capsulated, grey-brownish in color and with firm elastic consistence. The histological findings revealed meningioma--meningotheliomatose variant.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/12. fourth ventricle neurocytoma with lipomatous and ependymal differentiation.We report the case of a 4-year-old girl with a fourth ventricle tumor diagnosed as a cerebellar liponeurocytoma which recurred, showing ependymal differentiation, 14 months after surgery. magnetic resonance imaging at initial presentation revealed a large mass in the fourth ventricle, and histology showed a neoplasm characterized by a combination of well-differentiated neurocytes and cells resembling adipocytes. The tumor recurrence was histologically identical to the original tumor in some regions, but with fewer adipose-like cells, while other areas presented an endocrine architecture with oligo-like or pleiomorphic cells, and rosette-like arrangements of tumoral cells were seen around the thin vessels, with features similar to cellular ependymoma. The cells in the liponeurocytoma areas expressed synaptophysin, chromogranin a, and epithelial membrane antigen. glial fibrillary acidic protein was expressed in some dispersed tumoral cells, in lipidized tumoral cells, and in reactive astrocytes. Cytokeratin was focally expressed in the ependymal region of the recurrence. The immunophenotype of our case, with glial, ependymal, and neuronal or neuroendocrine markers, suggest a neurocytoma with lipomatous and ependymal differentiation. This tumor resembled those derived from circumventricular organs. Its localization in the area postrema region led us to hypothesize that it may be derived from this circumventricular organ.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/12. Myxopapillary ependymoma of the fourth ventricle.Myxopapillary ependymoma is a benign variant of ependymoma, occurring almost exclusively in the cauda equina region of the back. Here, we report an extremely rare case of primary myxopapillary ependymoma, and also present our review of the existing literature. This tumor occurred in the fourth ventricle of a 62-year-old woman. The patient had complained of dizziness and general weakness, persisting for the prior 6 months. The patient underwent surgical removal of the tumor. Imaging studies of the spine were normal. Microscopically, the cut sections of the tumor revealed papillary formation surrounding areas containing both hyalinized blood vessels and myxoid degeneration. The histological findings were consistent with those of tumors originating in the filum terminale. The patient's postoperative course was uneventful, and she was doing well on follow-up, 15 months after surgery. This is the second reported case of fourth ventricular myxopapillary ependymoma.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/12. Synchronous endoscopy and microsurgery: a novel strategy to approach complex ventricular lesions. Report of three cases.Simultaneous endoscopic and microsurgical (synchronous) approaches represent a new paradigm in the treatment of complex ventricular lesions. This technique is well suited for lesions that involve multiple ventricular or cisternal compartments, have a nonlinear axis, or adhere to critical anatomical or neurovascular structures. Two distinct operative corridors, one endoscopic and the other microsurgical, are used during synchronous approaches to address such lesions, increasing the likelihood of a safe and complete resection. The authors present the cases of two children and an adult treated via synchronous approaches. All patients had multi-compartmental lesions involving the ventricles and/or cisterns. One patient presented with a suprasellar Rathke cyst with a significant third ventricular component, one with a hypothalamic hamartoma having a substantial cisternal component, and the remaining patient with a choroid plexus papilloma in the left lateral ventricle that extended from midbody to the temporal horn. In the cases of the Rathke cyst and the hamartoma, debulking in the third ventricle and controlled detachment of the lesion from the hypothalamus were undertaken using endoscopy, and simultaneous resection of the suprasellar component was performed through a subfrontal craniotomy. In the case of the choroid plexus papilloma, selective cautery of the choroidal feeding vessels and detachment from the temporal tela choroidea were performed using endoscopy, and the tumor from the ventricular body to the atrium was resected via a craniotomy. In each case the resection concluded with the intersection of endoscopic and microsurgical fields. All three patients had good outcomes. Endoscopic and microsurgical approaches can be used concurrently to treat multicompartment ventricular and/or cisternal lesions with good results. The probable advantages of this method are more complete resection and improved safety.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/12. brain and spinal cord hemorrhage in long-term survivors of malignant pediatric brain tumors: a possible late effect of therapy.Three children with malignant primary CNS tumors treated with craniospinal radiotherapy developed intraparenchymal hemorrhages a median of 5 years following therapy in sites distant from the primary tumor. Radical surgical procedures disclosed fresh and old hematoma, gliosis, and necrosis in all 3 patients and an aggregation of abnormal microscopic blood vessels in two. No tumor was found. All 3 patients remain in long-term (greater than 10 years) continuous remission.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/12. Sarcomatous proliferation of the vasculature in a subependymoma.A case of a recurrent posterior fossa subependymoma in a 60-year-old man is reported. In the recurrent tumor, the vasculature had undergone apparent sarcomatous proliferation of the endothelial cells. The bizarre cells expanded and replaced the vessel walls, and stained for factor viii-related antigen. The literature on gliosarcomas arising in brain tumors other than high-grade gliomas is reviewed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/12. Meningiomas of the lateral ventricle.The authors present two cases of large meningiomas of the lateral ventricle. In both cases the first diagnosis of the disease was cerebral ischaemia. Tumours did not produce symptome of intracranial hypertension, and the most common symptoms of these tumours - hemianopia and papilloedema - were also not observed. Both tumours did not originate from the choroid plexus, probably developing from the tela conjunctiva of the vessels.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/12. Myxopapillary ependymoma of the lateral ventricle. A study on the mechanism of its stromal myxoid change.Reported was the first case of myxopapillary ependymoma arising from the right lateral ventricle of a 29-year-old Japanese male. The histological and ultrastructural findings were identical to those from the filum terminale. It was suggested that insudation of plasma proteins found within hyaline-thickened blood vessels in the tumor stroma represented the presence of previous long-standing anoxia and thus, circulatory disturbance would be closely related to the formation of the stromal myxoid change.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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