Resección Tubular Microquirúrgica de un Subependimoma Extenso del Ventrículo Lateral Izquierdo: Video Operatorio en 2D / Microsurgical Tubular Resection of an Extensive Subependymoma of the Left Lateral Ventricle: Operative Video in 2D

Introducción: Los subependimomas intracraneales son raros, representan el 0.2-0.7% de todos los tumores del sistema nervioso central1,2 y se originan en los ventrículos laterales en el 30-40% de los casos.3 Los síntomas usualmente se asocian a hipertensión endocraneana secundaria a hidrocefalia obstructiva.4 La resección completa del tumor es curativa en esta patología.5 El abordaje trans-surcal es seguro para lesiones ventriculares profundas y el uso de los retractores tubulares minimizan la retracción del parénquima cerebral evitando la compresión directa con valvas. Esto permite disminuir la presión del tejido cerebral que puede ocluir los vasos y producir isquemia local generando una lesión neurológica permanente. Descripción del caso: Se presenta el caso de una paciente de 66 años, diestra, con cefalea crónica que aumenta en frecuencia en el último mes. La resonancia cerebral contrastada muestra un tumor extenso en el ventrículo lateral izquierdo con signos de hidrocefalia obstructiva. Intervención: Se coloca la paciente en posición supina. Se hace una incisión bicoronal y se hace un abordaje trans-surcal F1/F2 izquierdo. Se coloca un retractor tubular guiado con el puntero de neuronavegación, introduciéndolo directamente en el parénquima cerebral y fijándolo al soporte de Leyla. Se colocó un catéter de ventriculostomía contralateral y se retira a las 48 horas sin complicaciones asociadas. La resonancia contrastada postoperatoria demuestra una resección completa del tumor. El análisis de patología reveló un subependimoma grado I de la clasificación de la Organización Mundial de la Salud. La paciente presentó transitoriamente apatía y pérdida del control del esfínter urinario que resolvieron completamente a las 3 semanas después de la cirugía. Se firmó un consentimiento firmado para la publicación de la información utilizada en este trabajo. Conclusión: La resección completa microscópica de un subependimoma extenso del ventrículo lateral izquierdo es factible a través de un abordaje tubular transulcal.

Introduction: Intracranial subependymomas are rare, representing only 0.2-0.7% of all central nervous system tumors1,2 and arise in the lateral ventricles in 30-40% of the cases.3 Symptoms depend on tumor location and usually arise when the cerebrospinal fluid (CSF) is blocked, generating a consequent intracranial hypertension.4 Microsurgical gross-total resection is possible and curative for these tumors.5 The transcortical/trans-sulcal approach is a safe approach for the access of deep-seated intraventricular lesions. The use of tubular retractor systems minimizes retraction injury when passing through the cortex and deep white matter tracts. This allows a decrease in the pressure on brain tissue that can occlude the brain vessels and produce local ischemia and a consequent permanent neurological injury. Case description: This is a case of a 66-year-old woman who presented chronic headaches that increased in frequency in the last month. Enhanced-brain MRI demonstrated a large left ventricular lesion with signs of obstructive hydrocephalus. Procedure: Patient was positioned supine. A bicoronal incision was used to perform a left frontal craniotomy. An F1/F2 transcortical/trans-sulcal approach was used. A guided tubular retractor is placed with the neuronavigation pointer, inserting it directly into the brain parenchyma and fixing it to the Leyla support. Postoperative postcontrast MRI demonstrated a complete resection of the tumor. Histopathological analysis revealed a subependymoma (World Health Organization Grade I). The patient presented transient apathy and loss of urinary sphincter control that completely resolved 3 weeks after surgery. Written informed consent was obtained for publication of information used for this work. Conclusions: A complete microsurgical resection of a large left ventricular subependymoma is feasible through a trans-sulcal tubular approach.

Clinical value of Omniview combined with volume contrast imaging in measuring the posterior angle of fetal near-field lateral ventricle / 中国基层医药

Objective:To investigate the clinical value of Omniview combined with volume contrast imaging (VCI) in measuring the posterior angle of fetal near-field lateral ventricle.Methods:Fifty fetuses whose lateral ventricles were widened, corpus callosum was poorly developed, and who had hydrocephalus as indicated by routine ultrasonography performed between October 1, 2018 and December 31, 2019 in Hangzhou Obstetrics & Gynecology Hospital were included in this study. The width of the posterior angle of fetal near-field lateral ventricle was measured using routine ultrasonography, Omniview-VCI technique, and magnetic resonance imaging (MRI) in each fetus and compared among the three techniques.Results:The width of the posterior angle of fetal near-field lateral ventricle measured by Omniview-VCI and MRI techniques was (1.17 ± 0.15) cm and (1.20 ± 0.12) cm, respectively, which was significantly greater than that measured by routine ultrasonography [(1.11 ± 0.13) cm, t = 2.137, 3.597, both P < 0.05]. There was no significant difference in the width of the posterior angle of fetal near-field lateral ventricle measured by Omniview-VCI technique versus MRI technique ( t = 1.104, P > 0.05). The mean examination cost and waiting time of Omniview-VCI technique were (222.15 ± 3.20) yuan and (0.24 ± 0.04) days, which were less or shorter than those of MRI technique [(597.23 ± 11.02) yuan, (1.02 ± 0.10) days, t = 213.126, 51.210, both P < 0.05]. Conclusion:Omniview-VCI technique can replace MRI and accurately measure the posterior angle of fetal near-field lateral ventricle. It provides a more simple, fast and effective method for evaluating fetal near-field lateral ventricle, and can become a conventional application technique.

Sonographic Assessment of Normal Fetal Cerebral Lateral Ventricular Diameter at Different Gestational Ages

Abnormal dilatation of ventricles has been shown to be the most common abnormality of the brain & fetus in most of the geographical zones, but the normal dimension of the fetal lateral ventriclein south-southgeopolitical zones of Nigeria has not been evaluated.The aim of this study was to determine the normal feto-lateral ventricular diameter using ultrasound at different gestational ages. Measurement of the fetal-lateral ventricular diameter was obtained from 685 fetuses of pregnant mothers that met the inclusion criteria during routine ultrasound scan in Calabar metropolis. Measurement of the ventricular diameter was taken at the levelof the atria, measured according to Australian society for ultrasound in medicineguidelines.Original ResearchArticle

Morphometric Study Of Posterior Horn Of Lateral Ventricle And Its Correlation With Age And Side: A Ct Study

Enlargement of lateral ventricle is most striking feature after sixth decade of life. Regression of brain is normalageing process. But there are marked individual variations in this process. Lateral ventricular contours arerelatively constant, except for the occipital horns. Two major changes that may occur in elderly individualwithout neurologic deficits is enlargement of ventricles and cortical atrophy. This study is focusing on thechanges in posterior horn of lateral ventricle in different age groups. Aim of this study is to statistically analysethe length of the posterior horn of lateral ventricle in human and to correlate the changes in relation to age andside. Method: The CT images of 150 adult individuals (age group 20-80yrs) was studied in both males andfemales. Length of posterior horn of lateral ventricle was measured using dicomworks software. Result: Meanvalue of length of the posterior horn increases on both sides as the age increases. Values are larger in 61-80years. In relation to the side, the length of posterior horn is greater on the left side as compared to the right side.

Microsurgical management of meningiomas in the trigone of the lateral ventricle / 医学研究生学报

Objective Meningiomas in the trigone of the lateral ventricle are characterized by deep location and low inci-dence. A few studies have been done on its treatment at home and abroad. This study was to explore the access,techniques,and clini-cal effect of microsurgery for lateral ventricular trigone meningiomas (LVTM). Methods We retrospectively analyzed the clinical data about 36 cases of LVTM treated by microsurgery in our hospital from December 2011 to December 2015. The operation involved lumbar cistern tube drainage, intraoperative drainage of cerebrospinal fluid, a unilateral parieto-occipital U-shaped cut, approach through the interparietal fissure,a sagittal incision about 3 cm long at the interparietal fissure for exposure and resection of the tumor. We followed up the patients for a mean of 17 months postoperatively and analyzed the results and complications. Results Simpson grade I removal of the tumors was achieved in all the 36 cases. Postoperative complications included homonymous hemianopia in 4 cases, central nervous system infections in 3,secondary epilepsy in 2,subcutaneous hydrops in 2,and intratumoral hemorrhage in 1 (which necessitated a second operation). Extended temporal horn of the right lateral ventricle occurred at 32 months after surgery,which was treated by fistulation. Homonymous hemianopia was improved in 2 of the 4 ca-ses. All the patients were capable of daily life activities and none experienced recurrence. Conclusion Sufficient preoperative evalu-ation of the tumor characteristics,rational selection of surgical approach,and expert operation techniques are the key factors for the mi-crosurgical treatment of meningiomas in the trigone of the lateral ventricle.

A study of brain development in newborns with cardiac septal defect by MRI / 实用放射学杂志

Objective To assess the brain development of newborns with cardiac septal defects by MRI.Methods The brain MR images of 150 newborns with cardiac septal defects and 50 normal newborns were analyzed retrospectively.We evaluated the brain development by measuring the four indices of lateral ventricle:anterior horn index (F/F'),body index (D/D'),caudate nucleus index (C/C')and Evans index.Independent samples t test was used to compare the differences between the two groups,and the possible positive diagnostic cut-off points were calculated by using the nonparametric ROC analysis.Results There were no significant differences between the congenital heart disease group and the control group in the two indices:F/F'[(0.301±0.035)vs (0.296±0.031);t=1.035,P>0.05]and Evans index [(0.239±0.052)vs (0.233±0.025);t=0.778,P>0.05].The values of D/D'[(0.261±0.039)vs (0.234±0.032);t=3.873,P<0.05)] and C/C'[(0.138±0.018)vs (0.124±0.015);t=4.479,P<0.05]were significantly higher in the congenital heart disease group than in the control group.In the congenial heart disease group,the area under the ROC curve obtained by D/D'and C/C'were 0.698 and 0.750,respectively.The maximum Yuedeng index corresponding to the D/D'value and the C/C'value were 0.28 and 0.12,respectively. Conclusion The body index(D/D')and the caudate nucleus index(C/C')are sensitive to evaluate the differences of the brain volume between the newborns with cardiac septal defects and the normal newborns.It is helpful to find the abnormal brain volume when the value of D/D'is greater than 0.28 and the value of C/C'is greater than 0.12.

Corpus callosum and ventricle: MRI determination of dementia in Turkish population and healthy geriatric subjects / Cuerpo calloso y ventrículo: determinación de demencia con RM en una población turca y sujetos geriátricos saludables

SUMMARY: The aim of this study was to identify the values of corpus callosum sections and ventricles in Dementia and healthy geriatric subjects using magnetic resonance imaging (MRI) and to establish both gender differences and differences between groups. The MRI results of 163 geriatric subjects (81 healthy individuals; 82 Dementia subjects) aged 60-89 years were studied. The midsagittal and axial images were used for measurements of the corpus callosum and lateral ventricle, respectively on MRI. The mean values of the widths of genu, body, splenium, height of the corpus callosum, longitudinal dimension of the corpus callosum and brain were 8.74±1.53 mm, 5.37±0.75 mm, 9.37±1.33 mm, 25.42±2.89 mm, 70.99±3.86 mm, 148.87±6.67 mm and 8.51±1.93 mm, 5.37±0.84 mm, 9.74±1.17 mm and 25.67±2.88 mm, 72.41±4.99 mm, 153.66±8.00 mm in females and males of healthy geriatric age, respectively. The same measurements were found to be 6.90±1.66 mm, 4.33±0.76 mm, 7.94±1.38 mm, 24.42±3.11 mm, 69.01±4.52 mm, 149.18±7.13 mm and 7.55±1.98 mm, 4.56±1.02 mm, 8.60±1.58 mm, 23.96±3.51 mm, 73.42±3.81 mm, 155.38±8.39 mm in females and males with Dementia, respectively. Additionally, the means of the frontal horn width and Evans index measurements were lower in healthy geriatric subjects, whereas the transverse inner diameter of the skull were higher in healthy geriatric subjects than dementia subjects in both sexes. The observations presented in this report have defined anatomic parameters of healthy and dementia geriatric subjects that need to be taken into consideration for reference data to determine sex discrepancies, and be helpful for radiologists and clinicians.

RESUMEN: El objetivo del estudio fue identificar los valores de las secciones del cuerpo calloso y los ventrículos en una población turca de sujetos geriátricos sanos y con demencia, mediante resonancia magnética (RM) y establecer diferencias tanto de sexo como diferencias entre los grupos. Se estudiaron los resultados de 163 sujetos geriátricos (81 sujetos sanos, 82 sujetos con demencia) de 60-89 años. Las imágenes sagitales y axiales se utilizaron para las realizar las mediciones del cuerpo calloso y del ventrículo lateral en RM, respectivamente. Los valores medios de los anchos de rodilla, cuerpo, rodete, altura del cuerpo calloso, dimensión longitudinal del cuerpo calloso y del cerebro fueron de 8,74 ± 1,53 mm, 5,37 ± 0,75 mm, 9,37 ± 1,33 mm, 25,42 ± 2,89 mm, 70,99 ± 3,86 mm, 148,87 ± 6,67 mm y 8,51 ± 1,93 mm, 5,37 ± 0,84 mm, 9,74 ± 1,17 mm y 25,67 ± 2,88 mm, 72,41 ± 4,99 mm, 153,66 ± 8,00 mm en mujeres y hombres sanos, respectivamente. Las mismas medidas fueron de 6,90 ± 1,66 mm, 4,33 ± 0,76 mm, 7,94 ± 1,38 mm, 24,42 ± 3,11 mm, 69,01 ± 4,52 mm, 149,18 ± 7,13 mm y 7,55 ± 1,98 mm, 4,56 ± 1,02 mm, 8,60 ± 1,58 mm, 23,96 ± 3,51 mm, 73,42 ± 3,81 mm, 155,38 ± 8,39 mm en mujeres y hombres con demencia, respectivamente. Además, las medias de la anchura del asta frontal y las mediciones del índice de Evans fueron menores en sujetos geriátricos saludables, mientras que el diámetro interno transversal del cráneo fue mayor en sujetos geriátricos sanos que en los sujetos con demencia en ambos sexos. Las observaciones presentadas en este informe han definido los parámetros anatómicos de los sujetos sanos y con demencia que deben tenerse en cuenta para identificar los datos de referencia para determinar las discrepancias de sexo y que puedan ser útiles para los radiólogos y los médicos.

Study of the lateral ventricular in patients with Alzheimer's disease at 3.0T MR and MIMICS reconstruction / 实用放射学杂志

Objective To evaluate cerebral parenchymal atrophy of patients with Alzheimer's disease(AD)through the compara-tive analysis of the volume and morphology of the brain ventricle between patients with AD and normal elderly.Methods 20 patients with AD and 20 normal elderly people were scanned at 3.0T MR,and lateral ventricle section images were achieved,and the lateral ventricle volume and the anterior horn,posterior horn and temporal horn of the lateral ventricle were calculated by analyzing the re-construction of section images with MIMICS software from Belgian.Results As compared with normal elderly group,the patients with AD exhibited significantly increased the volume of left ventricular volume(LV),right ventricular volume (RV)and total vol-ume (TV)(P<0.05).Angle of bilateral anterior horn and temporal horn but not posterior horn of the lateral ventricle in patients with AD were significantly higher than that in normal elderly (P<0.05).The volume of the left,right and total cerebral ventricle, the angle of the anterior horn of the left and right lateral ventricle and the angle of the temporal horn of the left and right lateral ven-tricle were negatively correlated with MMSE (P<0.05).Conclusion Patients with AD exhibites significantly greater volume and an-gle of the lateral ventricular than normal elderly people.These related data measured can predict brain parenchymal atrophy of pa-tients with AD more conveniently and accurately.

Ocular manifestations of intraventricular trigonal meningioma and the associated optic radiation injury / 国际眼科杂志(Guoji Yanke Zazhi)

Abstract? AIM: To analyze the ocular manifestations of meningiomas in the trigone of the lateral ventricle, discuss the relevant factors of visual impairment in these patients and things need attention clinically.?METHODS:Retrospectively study on the clinical data of 90 eyes in 45 patients diagnosed of trigonal meningiomas treated at Beijing Tian Tan Hospital from October 2011 to October 2015.Preoperative examinations including visual acuity, optic disc findings, visual field, size of tumors and other change in MRI were analyzed.?RESULTS: Patients'age was 12-68 years old ( mean 41.7 ±13.7 years ). Male/female ratio was 1 ∶4.6. Decreased visual acuity occurred in 18 eyes.Optic disc edema was found in 24 eyes and optic disc pale in 6 eyes. Fourty -seven eyes had visual field defect, mostly homonymous hemianopia or defect. The maximum diameter of tumors was 2.1-9.6cm (4.8±1.7cm).Range of tumor volume was 3.02-193.2cm3(48.3±47.8cm3).A positive correlation of preoperative visual field defect was found with tumor volume, tumor maximum diameter, and brain midline shift respectively. While the preoperative visual field defect was not found any correlation with age, gender, course, and the enlargement of the ventricle and the edema of the tissue around the tumors. After Mann-Whitney U test, the differences on tumor volume, the maximum diameter of tumors, and brain midline shift between the two groups were significant.? CONCLUSION: Patients with trigonal meningiomas often have ocular signs and symptoms.The major reason of visual field defect is the damage of optic radiation around the tumor.The specific position of injured optic radiation determines the type and extent of visual field defect.Both ophthalmologist and neurosurgeon should pay attention to tumors nearby posterior visual pathway. Doing neurophthalmology examinations for these patients and realizing the position between the tumor and posterior visual pathway will be helpful and necessary in surgical planning.

Quiste epidermoide del ventrículo lateral / Epidermoid cyst of the lateral ventricle

Los quistes epidermoides del ventrículo lateral son lesiones extremadamente infrecuentes originadas por la inclusión de elementos epiteliales al momento del cierre del tubo neural. Son tumores de lento crecimiento y se presentan clínicamente con síntomas inespecíficos. La Resonancia Magnética de encéfalo permite realizar un diagnóstico presuntivo, que se confirma por hallazgos característicos durante la cirugía. El diagnóstico de certeza es por la anatomía patológica en donde se observa un epitelio escamoso estratificado. Se presenta un caso de una mujer de 39 años operada por vía microquirúrgica con asistencia endoscópica.

Epidermoid cysts occurring within the lateral ventricles are uncommon lesions. These tumors are of developmental etiology, due to migration of epiblast inclusion at the time of neural tube occlussion of the neural tube. They are slow growing tumors and clinical presentation is nonspecific. Magnetic Resonance is suggestive of a cystic lesion, and is confirmed to be a epidermoid cyst at operation. Histopathology reveals typical stratified squamous epithelium. A case of a woman of 39 years old woman operated on with microsurgery and endoscopic assistance is presented..

Open Lip Schizencephaly with Agenesis of Corpus Callosum: A Rare Embryological Defect In Combination.

A five week old newborne presented with recurrent abnormal movements . The child was borne of normal parents with non consangious marriage . There was no history of any ailment of mother during pregnancy and she was not on any drugs. The baby was borne by normal delivery and The CT Scan of the head showed Schizencephaly with Agenesis of Corpus Callosumwith gyralmalformation. Therewere no associated anomalies. Facial features were well developed and the muscle tone and power of the child was normal. The blood investigations were normal as was metabolic profile.

The Pterional-Transsylvian Approach for Tumor in the Temporal Horn: A Case Report

A variety of surgical approaches to temporal horn tumors of the lateral ventricle have been described. Magnetic resonance imaging (MRI) and angiography are the preferred modalities for preoperative evaluation and provide important information for the choice of surgical approach. A 59-year-old man was referred to our hospital due to confusion and gait disturbance. On enhanced MRI, a homogeneous enhanced solitary mass was observed within the temporal horn of the left lateral ventricle with transependymal extension. The lesion was accompanied by increased hypervascular tumor blush on preoperative cerebral angiography. Subtotal removal of the temporal horn tumor was performed because the lesion was identified as lymphoma during surgery. The postoperative course was un-eventful. The patient was referred to the oncology department for conventional chemotherapy. Adjuvant chemotherapy improved the clinical outcome. The pterional-transsylvian approach was beneficial for partial removal of the tumor and tissue diagnosis in this case.

Surgical challenges for lateral ventricle meningiomas: A consecutive series of 21 patients / 华中科技大学学报（医学）（英德文版）

Lateral ventricular meningiomas (LVMs) are especially rare, and they often remain "silent" until they become very large. Several surgical approaches exist, but the optimal surgical strategy for them remains a challenge. The incidence, clinical features, radiological manifestations, pathological findings, and especially the surgical strategy in 21 patients with LVMs were analyzed retrospectively. The mean age of patients was 42.7 years (range, 17 to 78 years). Raised intracranial pressure was the main presenting symptom. The definite diagnosis of LVMs in most cases was made by computed tomography (CT) or magnetic resonance imaging (MRI). Six patients were subjected to plain CT scans, 15 to contrast MR scans, and 4 to a magnetic resonance angiogram (MRA). Large tumors were seen in most cases with an average diameter of more than 4.3 cm. Of the 21 cases of LVMs in our series, LVMs were resected in 16 cases via a posterior parieto-occipital transcortical approach, 2 cases via a transcallosal approach, and 3 cases via a posterior middle temporal gyrus approach. In 8 out of 21 cases, the tumors were located in the left lateral ventricle. The gross total surgical excision was achieved in 18 (86%) patients, and all LVMs were pathologically confirmed to be benign. Nine patients were followed up (range: 11 months-4.6 years). Eight (88.9%) cases obtained good recovery and one (11.1%) obtained moderate disability. Four approaches are available for the surgical treatment of LVMs. The choice of surgical approaches depends on tumor location, laterality, size and extension, and the function of the brain must be taken into account. Intracapsular resection and piecemeal resection of LVMs can be safely and easily performed. Preoperative MRA scan is important to know the feeder of LVMs and peripheral blood supply.

Ultrasound Reference Range for Diameters of Posterior Atrium of Lateral Ventricles for Normal Nigerian Foetuses, at the University College Hospital (UCH) Ibadan, Nigeria: A Cross – Sectional Study.

Aims: The diameter of the posterior atrium of the lateral cerebral ventricles (PALV) does not vary substantially in size during foetal development and has thus become a stable marker for the identification of foetal ventriculomegaly in developed countries. Currently, the accepted upper limit of PADLV is 10 mm. Ventricular atrial diameters greater than 10mm require more radiological evaluation to rule out ventriculomegaly. The aim of this study was to establish the normal range of values for the posterior atrium [PA] of foetal lateral ventricles in our environment and to determine a cut-off value for prenatal diagnosis of ventriculomegaly. Methods: The mean of two measurements was obtained from the transverse diameter of the atrium of the lateral ventricles of foetuses that met the inclusion criteria, as part of the routine obstetric ultrasound scan at the antenatal clinic or ultrasound suite of radiology department of the University College Hospital (UCH), Ibadan. The SPSS version 15 was used to analyse the data obtained. Results: The mean posterior atrial diameter [PAD] of the lateral ventricl was 6.5mm with standard deviation (SD) 1.3mm and mean ±2SD 3.9–9.1mm. Male foetuses had larger atrial diameters than female. Student’s t-test and Pearson’s correlation coefficient were used to explore association. Conclusion: With the existing resources in our environment, prenatal screening for ventriculomegaly during routine obstetric scan is achievable. Measurement of 10mm is a reasonable upper limit of normal in our environment. Foetuses with larger values need further evaluation to rule out hydrocephalus.

Application of MRI volume rendering in surgical approach by superior temporal sulcus-temporal horn of lateral ventricle / 吉林大学学报(医学版)

Objective To acquire some related data of surgical approach through brain superior temporal sulcus to temporal horn of lateral ventricle by MRI volume rendering, and to orientate the point of superior temporal sulcus on the lateral surface which is closest to temporal horn of lateral ventricle,and to find out the best entrance point of surgical approach through superior temporal sulcus to temporal horn of lateral ventricle.Methods 120 adult cases of MRI scanning specimens were chosen for measurement. MRI volume rendering technology was used to rebuild the brain 3D model for the measurement of the full length of superior temporal sulcus S1 .Then cutting along the prependicular to the direction of the long axis of the temporal lobe with 1.0 mm spacings,the coronal sections were obtained,and the distance from superior temporal sulcus to temporal horn of lateral ventricle was ordinally measured and the shortest distance S2 was made sure.And the depth of superior temporal sulcus S3 was detected. The corresponding point on the surface of the brain at superior temporal sulcus according to the point leading the shortest distance S4 was determined. The ratio of S4 to S1 M was calculated. The angle between the shortest distance and median sagittal plane asαwas determined.All the samples were measured on both sides of the brain and all the data were compared.Results The S1 of the 120 cases was (159.56 ± 17.55)mm on the left and (164.35± 15.07)mm on the right,there was no statistical difference between two cerebral hemispheres(P>0.05);the S2 was (8.18±0.96)mm on the left and (7.81±0.90)mm on the right,there was no statistical difference between two cerebral hemispheres(P>0.05);the S3 was (12.19±1.43)mm on the left and (11.57± 1.33)mm on the right,there was no statistical difference between two cerebral hemispheres(P>0.05);the S4 was (100.88±16.09)mm on the left and (104.15±14.49)mm on the right,there was no statistical difference between two cerebral hemispheres(P>0.05);the M was (0.63 ±0.07)on the left and (0.63 ±0.06)on the right,there was no statistical difference between two cerebral hemispheres(P>0.05);theαwas (55.80±3.64)°on the left and (56.46±4.17)°on the right,there was no statistical difference between two cerebral hemispheres(P>0.05). Conclusion The point at the front side 3/5 of superior temporal sulcus may be the ideal surgical approach entrance point.The distance from the point to temporal horn of lateral ventricle is shortest.It indicates that the approach can reduce the damage of brain tissue.

Preliminary study on the size-changing lateral cerebral ventricle in second-third trimester normal pregnancy with gestational age / 实用放射学杂志

Objective To explore the growing change of sizes of lateral cerebral ventricle in second-third trimester normal fetuses in MRI,to provide the normal reference for clinical monitoring.Methods MRI findings in 98 normal second-third trimester fetuses were retrospectively analyzed.The fetuses were divided into 6 groups according to gestational age (unit:week)including 18-21,22-25,26-29,30-33,34-37 and 38-40 weeks,respectively.The maximum transverse sizes of fetal atrium and occipital horns of lateral ventricle (cm)were measured.The SigmaStat statistical program was used for statistical analysis.Results The length of lateral ventricle atrium horn in 6 groups were 0.35 ± 0.03,0.33 ± 0.05,0.31 ± 0.04,0.30 ± 0.03,0.26 ± 0.05 and 0.25 ± 0.04,respectively,and the ventricle length of occipital horns were 0.91± 0.09,0.84 ± 0.09,0.84 ± 0.1 1,0.81 ± 0.13,0.80 ± 0.1 1 and 0.74 ± 0.13,respectively.The length of lateral ventricle atrium horn and ventricle occipital horns among some differ-ent groups showed significant differences (P <0.05).The length of fetal ventricle atrium and occipital horn were reduced gradually with gestational ages.Conclusion The ventricular length of atrium and occipital horn in second-third trimester normal fetuses reduce gradually with gestational ages.

Evaluation of the lateral ventricle using MRI in normal micropigs / 대한수의학회지

This study was undertaken to assess the lateral ventricle, which was some portion of brain and related to congenital anomalies, from 1, 2, 4, and 8 months of age in healthy micropigs. They were induced general anesthesia and performed magnetic resonance imaging (MRI) with a 0.3 Tesla magnet. Each age group was evaluated by three subjects such as lateral ventricular volume, ventricular volume ratio and asymmetry. T1 weighted transverse images were acquired for calculation of lateral ventricular and corresponding brain parenchyma areas. The ratio of bilateral ventricle areas used to analyze the asymmetry. The mean ventricular volumes of each month were 676.74 +/- 25.58 mm3 (1 month-old), 630.64 +/- 143.84 mm3 (2 month-old), 992.12 +/- 106.03 mm3 (4 month-old) and 1172.62 +/- 237.57 mm3 (8 month-old), respectively. The ventricular volume ratio was the smallest at 2 month-old and re-increased from that age. The ratio was significantly different between 2 month-old and other age groups (p < 0.05). The value of bilateral area ratio showed within 1.5 in all experimental animals. Consequently the lateral ventricle showed a positive correlation with aging and symmetric shapes in both sides. The developmental pattern of the lateral ventricle provides basic data in micropigs as an experimental animal model for physiological and neurosurgical approach.

Impact of venom nerve growth factor on neural progenitor cell proliferation and migration after cerebral ischemia/reperfusion injury in rats / 中国脑血管病杂志

Objective: To investigate the impact of venom nerve growth factor (vNGF) administered via lateral ventricle on neural progenitor cell proliferation and migration after cerebral ischemia/reperfusion injury in rats. Methods: Ninety healthy and clean male Wistar rats were randomly allocated into 2-day, 7-day, and 14-day groups. Then they were redivided into 5 subgroups at each time point: vNGF 25 U, vNGF 50 U, vNGF 100 U, control, and sham operation. The rat focal cerebral ischemia/reperfusion injury models of the control group and each vNGF subgroup were established. Corresponding dose of vNGF or isotonic saline was administered via the lateral ventricular cannula in all the subgroups according to the specified time points. Immunohistochemical method was used to detect the numbers of DCX positive neural precursor cells around the ischemic cortex and hippocampus CA3/Dentate gyrus in rats of each group. Results: Circled digit oneAfter administering vNGF via the lateral ventricle at each time point, the Longa's scores of the neurological function in all the vNGF subgroups were lower than those in the control group. There were statistical significances (P<0.01). Circled digit twoThe DCX-positive cells in the peri-ischemic cortex and hippocampus CA3/dentate gyrus showed the same change trend. The numbers of DCX positive cells in the 7-d subgroup was higher than those in the 2- and 14-d subgroups when the vNGF dose was the same. There were statistical significances (P < 0.01). Circled digit threeIn comparison of the subgroups with different vNGF doses at the same time points, the numbers of DCX positive cells in the vNGF 50 U subgroup was higher than those of vNGF 25 U and 100 U subgroups. There were statistical significances (P < 0.01). Circled digit fourThe numbers of DCX positive cells at each time point in the vNGF subgroups were significantly higher than those in the control group. There were statistical significances (P < 0.05). Conclusion: After administering vNGF via the lateral ventricle, it may increase the numbers of DCX positive neural precursor cells in the peri-ischemic cortex and hippocampus CA3/dentate gyrus after cerebral ischemia/reperfusion injury in rats.

Accuracy of the Free Hand Placement of an External Ventricular Drain (EVD) / 대한뇌혈관외과학회지

OBJECTIVE: Free hand insertion of an external ventricular drain (EVD) is one of the most common emergency neurosurgical procedures, usually performed on critically ill patients. Complications such as infection and hemorrhage that accompany the placement of an EVD have been studied thoroughly, but few reports have focused on the accuracy of EVD positioning. As a result, the authors of this paper retrospectively studied the accuracy of tip positioning in the placement of an EVD. METHODS: One hundred and thirteen emergency EVDs were performed through Kocher's point during the past 3 years. All patients underwent the following procedures: at least one routine post-EVD computed tomographic (CT) scan that was retrospectively reviewed for accuracy of the EVD tip position, calculation of the Evan's index, and measurement of the intracranial length of the EVD. We divided the EVD tip position into 6 groups as follows:1) ipsilateral frontal horn of the lateral ventricle, 2) contralateral frontal horn of the lateral ventricle, 3) third ventricle, 4) body of the ipsilateral or contralateral lateral ventricle, 5) basal cisterns, or 6) brain parenchyma. Among the 6 groups, only the ipsilateral frontal horn group was considered to be the correct position for the EVD tip. RESULTS: The mean age of the patients was 55.6+/-15.3 years (age range, 12~90 years), and the most common indication for the EVD was supratentorial intracerebral hemorrhage (ICH) and intraventricular hemorrhage (IVH) (57.5%). Forty-five out of a total of 113 EVDs were placed by inexperienced neurosurgical trainees, and the remaining 68 were placed by experienced practitioners. Among 113 post-EVD CT scans, 48 EVD tips (42.5%) were in the ipsilateral frontal horn of the lateral ventricle (considered to be the correct position); 22 (19.5%) were in the third ventricle, 16 (14.1%) in the body of the ipsilateral or contralateral lateral ventricle, 14 (12.4%) in the contralateral frontal horn of the lateral ventricle, 11 (9.7%) within the brain parenchyma and 2 (1.8%) in the basal cistern. The mean estimated EVD length was 57+/-8.4mm. The mean length of EVDs that were positioned in the ipsilateral frontal horn was 55+/-4.3 mm, whereas the mean lengths of EVDs in the parenchyma and basal cistern were 64+/-14mm and 72+/-3.5mm, respectively. In addition, there was no statistically significant relationship between the surgeon's experience and the accuracy of the position of the EVD tip (p > 0.05). CONCLUSION: Emergency free hand placement of an EVD might be an inaccurate procedure. Further multi-institutional prospective studies are required to assess the accuracy and complications of free hand insertion of EVDs in an emergency setting. Studies are also needed on the feasibility of routine use of intra-operative neuro-navigation of other guidance tools, such as ultrasonography.

Atypical Choroid Plexus Papilloma in an Adult

We present an extremely rare case of the atypical choroid plexus papilloma in an adult which developed at the trigone of right lateral ventricle. A 62-year-old woman presented with the history of intermittent and gradually progressive headache and left side hemiparesis for 6 months. The brain magnetic resonance image showed highly enhanced and well demarcated mass at the trigone of lateral ventricle attached to the choroid plexus. Gross total resection was performed by transcortical approach via the middle temporal gyrus. The tumor was diagnosed as an atypical choroid plexus papilloma. She had no neurologic deficit after the surgery. We report a case of atypical choroid plexus papilloma in adult and introduce newly classified pathologic characteristics of this tumor.