Article Figures & Data
Figures
- Figure 1
A 30-year-old woman presenting with a headache, blurry vision, and attacks of generalized body numbness for 2 months. A-C) Sagittal, coronal, and axial T1 Magnetic Resonance Imaging (MRI) with and without contrast enhancement showing third ventricular tumor with extension to the left lateral ventricle. She underwent left frontal craniotomy, frontal transcortical approach with subtotal excision of the tumor. The pathology revealed central neurocytoma. D-F) Postoperative with and without contrast enhancement T1 sagittal, coronal, and axial scans showing small residual tumor (arrow) under the corpus callosum. She postoperatively developed right side hemiparesis. In her follow-up, 6 and 9 months following surgery, her weakness improved significantly. We think the reason for her weakness is due to the retraction on the motor control areas.
- Figure 2
A 10-year-old girl presenting with 2 months history of a persistent headache, vomiting, and tremor in both hands. Additionally, she had 2 episodes of seizures. A-D) Contrast-enhanced T1 axial scans showing a mass occupying the left thalamus, crossing the midline, and infiltrating the third ventricle. She underwent resection via transcallosal approach with subtotal excision of the tumor. The pathology revealed central glioblastoma multiforme. E-H) Postoperative contrast-enhanced T1 axial scans showing small residual tumor. Postoperatively, the patient recovered very well with no neurological deficits.
Tables
Signs and symptoms Pediatrics Adults All patients n (%) Headache 9 (50) 20 (83) 29 (69) Nausea-vomiting 8 (44) 8 (33) 16 (38) Visual deficit* 2 (11) 8 (33) 10 (24) Seizures 5 (28) 2 (8) 7 (17) Change in behavior 2 (11) 4 (17) 6 (14) Unstable gait* 3 (17) 1 (4) 4 (10) Altered mental status 1 (6) 3 (13) 4 (10) Motor deficit* - 3 (13) 3 (7) Dizziness - 2 (8) 2 (5) Urine incontinence 2 (11) - 2 (5) Fever 1 (6) 1 (4) 2 (5) Tremor 1 (6) 1 (4) 2 (5) Neck stiffness 1 (6) - 1 (5) Tinnitus - 1 (4) 1 (2) Endocrine dysfunction - 1 (4) 1 (2) ↵* Some patients experienced more than one symptom
Histopathology Pediatrics Adults All patients n (%) Pineal region tumors 4 (10) 2 (5) 6 (14) Colloid cyst - 6 (14) 6 (14) Pilocytic astrocytoma 3 (10) 2 (5) 5 (12) Central neurocytoma 1 (2) 4 (10) 5 (12) Glioblastoma 1 (2) 3 (7) 4 (10) Atypical teratoid rhabdoid tumor 3 (7) - 3 (7) Ependymoma - 2 (5) 2 (5) Meningioma - 2 (5) 2 (5) Lymphoma - 1 (2) 1 (2) Choroid plexus papilloma 1 (2) - 1 (2) Anaplastic ependymoma 1 (2) - 1 (2) Anaplastic astrocytoma 1 (2) - 1 (2) Mature teratoma 1 (2) - 1 (2) Anaplastic oligodendroglioma - 1 (2) 1 (2) Craniopharyngioma - 1 (2) 1 (2) Glioneuronal tumor 1 (2) - 1 (2) Langerhans cell histiocytosis 1 (2) - 1 (2) Total 18 24 42 - Table 3
Postoperative complications and mortality in patients with lateral and third ventricular tumors
Complications all patients n (%) Seizure 5 (12) Hydrocephalus 5 (12) Wound site infection 3 (7) Intraventricular hemorrhage 2 (5) Weakness 1 (2) Vision disturbance 1 (2) Diabetes insipidus 1 (2) Mortality 2 (5) Hypothalamic syndrome 1 (2) Brain abscess and Ventriculitis 1 (2) *Some patients experienced more than one complication
Surgical approaches No. of all patients
n (%)Transcortical approach 19 (45 %) Endoscopic biopsy 8 (19 %) Transcallosal approach 5 (12 %) Infratentorial supracerebellar approach 3 (7 %) Pterional approach 3 (7 %) Endoscopic resection 2 (5%) Posterior fossa craniotomy 1 (2 %) Subfrontal approach 1 (2 %)
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