[A case of spontaneous 3rd ventriculostomy (author's transl)]. 1977

Y Miyasaka, and S Morii, and H Takagi, and T Ohwada, and K Yada

We have reported a rare case of spontaneous 3rd ventriculostomy with spontaneous arrest of obstructive hydrocephalus. A 41 year old man, who had had an intermittent headache for about a year, was admitted to the department of neurosurgery Kitasato University with chief complaints of sudden onset of severe headache, vomiting and disturbance of consciousness. At the time of admission, 30 minutes after the onset of symptoms, the positive neurological findings were delirious state of consciousness, miotic pupils with sluggish reaction to light, mild hemiparesis on the left site and slight nucnal rigidity. He lapsed into coma after two hours, however he gradually relieved from these symptoms since the forth hospital day. Cerebrospinal fluid was bloody. Radiograms of the skull revealed decalcification of posterior clinoid process and postero-inferior displacement of pineal calcification. Brain scanning and vertebral angiography demonstrated tumor stain in the posterior portion of the 3rd ventricle. Dimer-X ventriculography revealed the obstruction of posterior portion of the 3rd ventricle and the leakage of Dimer-X through the floor of the 3rd ventricle into the intrasellar subarchnoid space. The patient died after about one year from the onset of symptoms. Any signs of increased intracranial pressure had not been noticed since the forth hospital day; At autopsy we confirmed the posterior portion of the 3rd ventricle was obstructed by tumor. In the floor of the 3rd ventricle there was a round opening which was patient and measured about 3 mm in diameter. Microscopic examination of the tumor showed an oligodendroglioma. Neoplastic cells partially infiltrated into the surface facing to the 3rd ventricle and slight gliosis was observed around the site of rupture. The surface along the subarachnoid space was lined with pia-aracnoid membrane except at the site of rupture. In the past literatures only 6 cases of spontaneous 3rd ventriculostomy have been reported. Three cases were observed spontaneous arrest of obstructive hydrocephalus. Our case is the first reported case of spontaneous 3rd ventriculostomy through the floor of the 3rd ventriculostomy through the floor of the 3rd ventricle. We suggested the pathogenesis of spontaneous 3rd ventriculostomy is a result of destruction at normally weak points of 3rd ventricle (ex. anterior, posterior wall and floor of 3rd ventricle), which has the reultant internal hydrocephalus caused by recurrent obstruction of C.S.F. pathway or long-standing obstructive hydrocephalus.

UI MeSH Term Description Entries
D007427 Intracranial Pressure Pressure within the cranial cavity. It is influenced by brain mass, the circulatory system, CSF dynamics, and skull rigidity. Intracerebral Pressure,Subarachnoid Pressure,Intracerebral Pressures,Intracranial Pressures,Pressure, Intracerebral,Pressure, Intracranial,Pressure, Subarachnoid,Pressures, Intracerebral,Pressures, Intracranial,Pressures, Subarachnoid,Subarachnoid Pressures
D008297 Male Males
D009837 Oligodendroglioma A relatively slow-growing glioma that is derived from oligodendrocytes and tends to occur in the cerebral hemispheres, thalamus, or lateral ventricle. They may present at any age, but are most frequent in the third to fifth decades, with an earlier incidence peak in the first decade. Histologically, these tumors are encapsulated, relatively avascular, and tend to form cysts and microcalcifications. Neoplastic cells tend to have small round nuclei surrounded by unstained nuclei. The tumors may vary from well-differentiated to highly anaplastic forms. (From DeVita et al., Cancer: Principles and Practice of Oncology, 5th ed, p2052; Adams et al., Principles of Neurology, 6th ed, p655) Oligodendroblastoma,Anaplastic Oligodendroglioma,Mixed Oligodendroglioma-Astrocytoma,Mixed Oligodendroglioma-Ependymoma,Oligodendroglioma, Adult,Oligodendroglioma, Childhood,Oligodendroglioma, Well-Differentiated,Well-Differentiated Oligodendroglioma,Adult Oligodendroglioma,Adult Oligodendrogliomas,Anaplastic Oligodendrogliomas,Childhood Oligodendroglioma,Childhood Oligodendrogliomas,Mixed Oligodendroglioma Astrocytoma,Mixed Oligodendroglioma Ependymoma,Mixed Oligodendroglioma-Astrocytomas,Mixed Oligodendroglioma-Ependymomas,Oligodendroblastomas,Oligodendroglioma, Anaplastic,Oligodendroglioma, Well Differentiated,Oligodendroglioma-Astrocytoma, Mixed,Oligodendroglioma-Astrocytomas, Mixed,Oligodendroglioma-Ependymoma, Mixed,Oligodendroglioma-Ependymomas, Mixed,Oligodendrogliomas,Oligodendrogliomas, Adult,Oligodendrogliomas, Anaplastic,Oligodendrogliomas, Childhood,Oligodendrogliomas, Well-Differentiated,Well Differentiated Oligodendroglioma,Well-Differentiated Oligodendrogliomas
D002543 Cerebral Hemorrhage Bleeding into one or both CEREBRAL HEMISPHERES including the BASAL GANGLIA and the CEREBRAL CORTEX. It is often associated with HYPERTENSION and CRANIOCEREBRAL TRAUMA. Brain Hemorrhage, Cerebral,Cerebral Parenchymal Hemorrhage,Hemorrhage, Cerebral,Intracerebral Hemorrhage,Hemorrhage, Cerebrum,Brain Hemorrhages, Cerebral,Cerebral Brain Hemorrhage,Cerebral Brain Hemorrhages,Cerebral Hemorrhages,Cerebral Parenchymal Hemorrhages,Cerebrum Hemorrhage,Cerebrum Hemorrhages,Hemorrhage, Cerebral Brain,Hemorrhage, Cerebral Parenchymal,Hemorrhage, Intracerebral,Hemorrhages, Cerebral,Hemorrhages, Cerebral Brain,Hemorrhages, Cerebral Parenchymal,Hemorrhages, Cerebrum,Hemorrhages, Intracerebral,Intracerebral Hemorrhages,Parenchymal Hemorrhage, Cerebral,Parenchymal Hemorrhages, Cerebral
D002551 Cerebral Ventricle Neoplasms Neoplasms located in the brain ventricles, including the two lateral, the third, and the fourth ventricle. Ventricular tumors may be primary (e.g., CHOROID PLEXUS NEOPLASMS and GLIOMA, SUBEPENDYMAL), metastasize from distant organs, or occur as extensions of locally invasive tumors from adjacent brain structures. Intraventricular Neoplasms,Ventricular Neoplasms, Brain,Ventricular Tumors, Brain,Brain Ventricular Neoplasms,Cerebral Ventricle Tumors,Cerebroventricular Neoplasms,Neoplasms, Cerebral Ventricle,Neoplasms, Cerebroventricular,Neoplasms, Intraventricular,Neoplasms, Ventricular, Brain,Brain Ventricular Neoplasm,Brain Ventricular Tumor,Brain Ventricular Tumors,Cerebral Ventricle Neoplasm,Cerebral Ventricle Tumor,Cerebroventricular Neoplasm,Intraventricular Neoplasm,Neoplasm, Brain Ventricular,Neoplasm, Cerebral Ventricle,Neoplasm, Cerebroventricular,Neoplasm, Intraventricular,Neoplasms, Brain Ventricular,Tumor, Brain Ventricular,Tumor, Cerebral Ventricle,Tumors, Brain Ventricular,Tumors, Cerebral Ventricle,Ventricle Tumor, Cerebral,Ventricle Tumors, Cerebral,Ventricular Neoplasm, Brain,Ventricular Tumor, Brain
D002552 Cerebral Ventricles Four CSF-filled (see CEREBROSPINAL FLUID) cavities within the cerebral hemispheres (LATERAL VENTRICLES), in the midline (THIRD VENTRICLE) and within the PONS and MEDULLA OBLONGATA (FOURTH VENTRICLE). Foramen of Monro,Cerebral Ventricular System,Cerebral Ventricle,Cerebral Ventricular Systems,Monro Foramen,System, Cerebral Ventricular,Systems, Cerebral Ventricular,Ventricle, Cerebral,Ventricles, Cerebral,Ventricular System, Cerebral,Ventricular Systems, Cerebral
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006849 Hydrocephalus Excessive accumulation of cerebrospinal fluid within the cranium which may be associated with dilation of cerebral ventricles, INTRACRANIAL HYPERTENSION; HEADACHE; lethargy; URINARY INCONTINENCE; and ATAXIA. Communicating Hydrocephalus,Congenital Hydrocephalus,Obstructive Hydrocephalus,Post-Traumatic Hydrocephalus,Aqueductal Stenosis,Cerebral Ventriculomegaly,Fetal Cerebral Ventriculomegaly,Hydrocephalus Ex-Vacuo,Hydrocephaly,Aqueductal Stenoses,Cerebral Ventriculomegalies,Cerebral Ventriculomegalies, Fetal,Cerebral Ventriculomegaly, Fetal,Fetal Cerebral Ventriculomegalies,Hydrocephalus Ex Vacuo,Hydrocephalus Ex-Vacuos,Hydrocephalus, Communicating,Hydrocephalus, Congenital,Hydrocephalus, Obstructive,Hydrocephalus, Post-Traumatic,Post Traumatic Hydrocephalus,Stenoses, Aqueductal,Stenosis, Aqueductal,Ventriculomegalies, Cerebral,Ventriculomegalies, Fetal Cerebral,Ventriculomegaly, Cerebral,Ventriculomegaly, Fetal Cerebral
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012422 Rupture, Spontaneous Tear or break of an organ, vessel or other soft part of the body, occurring in the absence of external force. Ruptures, Spontaneous,Spontaneous Rupture,Spontaneous Ruptures

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