recurrence rate for these remnant cysts appears to be in the 5–10% range. In 1985, we developed a modification of the interhemispheric, transcallosal approach to include a subchoroidal fornix-sparing opening into the roof of the third ventricle for complete resection of colloid cysts of the third ventricle. 2 , 10 We describe our technique, report our results for 57 consecutive colloid cysts treated via this approach, and compare our results to those for endoscopic colloid cyst removal. Methods A retrospective analysis of 57 consecutive patients with colloid cysts
Search Results
Interhemispheric transcallosal subchoroidal fornix-sparing craniotomy for total resection of colloid cysts of the third ventricle
Clinical article
Scott Shapiro, Richard Rodgers, Mitesh Shah, Daniel Fulkerson, and Robert L. Campbell
Bilateral deep brain stimulation of the fornix for Alzheimer's disease: surgical safety in the ADvance trial
Francisco A. Ponce, Wael F. Asaad, Kelly D. Foote, William S. Anderson, G. Rees Cosgrove, Gordon H. Baltuch, Kara Beasley, Donald E. Reymers, Esther S. Oh, Steven D. Targum, Gwenn S. Smith, Constantine G. Lyketsos, and Andres M. Lozano
A lzheimer 's disease (AD) poses a significant threat to public health, and current treatment options have limited efficacy. New AD treatments are urgently needed. To this end, deep brain stimulation (DBS) of the fornix (DBS-f) was previously evaluated in a small pilot study. 12 In the United States, DBS is approved by the US FDA as a therapy for Parkinson's disease (PD) and essential tremor. The use of DBS has also been studied as a treatment for other neurological disorders, such as primary dystonia, obsessive-compulsive disorder, epilepsy, Tourette
Letter to the Editor. Fornix infarction
Alex Mamourian
of their study is that formal neuropsychological testing was not performed, however. Regarding their only case with symptomatic cerebral ischemia, it is worth noting the infarct seen in Fig. 4 of the paper involves not only the corpus callosum but also the bilateral columns of the fornix. Acute infarcts of the fornix would account for the patient’s disorientation at the conclusion of the procedure, and it was gratifying to read that symptoms resolved after 1 month. The same infarct pattern involving both the corpus callosum and the anterior fornix was illustrated
Colloid cysts of the third ventricle
John R. Little and Collin S. MacCarty
column of the fornix. Great care was taken not to disturb the main venous channels (internal cerebral, septal, and thalamostriate veins) in the region of the cyst. Postoperative Survival Three patients died during the first month after operation, two from bacterial meningitis and one from status epilepticus. There were two late postoperative deaths, one patient remained in a coma vigil state following surgery until he died 2 years later. The other died suddenly 5 weeks postoperatively. Death in the latter case may have been the result of acute CSF obstruction
Comparative anatomical analysis of the transcallosal-transchoroidal and transcallosal-transforniceal-transchoroidal approaches to the third ventricle
João Luiz Vitorino Araujo, José C. E. Veiga, Hung Tzu Wen, Almir F. de Andrade, Manoel J. Teixeira, José P. Otoch, Albert L. Rhoton Jr., Mark C. Preul, Robert F. Spetzler, and Eberval G. Figueiredo
accessing the third ventricle. 17 , 20 , 35 , 38 , 39 The transcallosal-transchoroidal approach to the third ventricle allows for adequate exposure of the middle and posterior regions of the ventricle. However, the fornix column limits exposure of the anterior region of the third ventricle. 30 , 38 There is evidence that a unilateral lesion of the fornix column has little or no impact on memory. 2 , 4 , 8 , 15 , 22 , 25 , 28 , 30 , 43 Various regions and structures participate in the memory circuit, and the fornix is just one of these structures. Changes to other parts
Comparative anatomical analysis of the transcallosal-transchoroidal and transcallosal-transforniceal-transchoroidal approaches to the third ventricle
João Luiz Vitorino Araujo, José C. E. Veiga, Hung Tzu Wen, Almir F. de Andrade, Manoel J. Teixeira, José P. Otoch, Albert L. Rhoton Jr., Mark C. Preul, Robert F. Spetzler, and Eberval G. Figueiredo
the third ventricle. 17 , 20 , 35 , 38 , 39 The transcallosal-transchoroidal approach to the third ventricle allows for adequate exposure of the middle and posterior regions of the ventricle. However, the fornix column limits exposure of the anterior region of the third ventricle. 30 , 38 There is evidence that a unilateral lesion of the fornix column has little or no impact on memory. 2 , 4 , 8 , 15 , 22 , 25 , 28 , 30 , 43 Various regions and structures participate in the memory circuit, and the fornix is just one of these structures. Changes to other parts of
Posterior transcallosal intervenous-interforniceal approach to a periaqueductal tumor
David S. Hersh, Katherine N. Sanford, and Frederick A. Boop
highlighted by the patient’s preoperative imaging. The coronal T2-weighted MRI demonstrates the separation of the forniceal crura posterior to the body of the fornix, and the lateral location of the crura relative to the internal cerebral veins. This view illustrates that a midline, posterior interhemispheric, transcallosal intervenous-interforniceal approach would provide a direct path to the underlying tumor. 3:51 Positioning and opening With this in mind, a posterior transcallosal intervenous-interforniceal approach was performed. The patient was placed in the MRI
Expanding cyst of the septum pellucidum
Case report
John A. Lancon, Duane E. Haines, Frank A. Raila, Andrew D. Parent, and V. V. Vedanarayanan
discrimination were normal. There was no ataxia. Magnetic Resonance Studies A large cyst of the septum pellucidum was seen on T 1 - and T 2 -weighted and proton-density magnetic resonance (MR) imaging ( Fig. 1 ). The cyst extended posteriorly to the level of the splenium (cavum septum pellucidum et vergae) and displaced the fornix caudally ( Fig. 1A ). There was mild ventriculomegaly but no transependymal edema ( Fig. 1B ). The septal, caudate, and internal cerebral veins were identifiable ( Fig. 2 ). There were no abnormalities of the size or signal characteristics of
Neural and vascular architecture of the septum pellucidum: an anatomical study and considerations for safe endoscopic septum pellucidotomy
Laszlo Barany, Cintia Meszaros, Oliver Ganslandt, Michael Buchfelder, and Peter Kurucz
T he medial wall of the lateral ventricle’s frontal horn is formed by the septum pellucidum, which stretches between the corpus callosum and the fornix . 30 , 36 The endoscopic fenestration of this structure (endoscopic septum pellucidotomy [ESP] or septostomy) is a well-accepted treatment for patients with specific forms of hydrocephalus 1 , 10 , 13–15 , 27 , 28 , 32 , 35 or with a symptomatic septum pellucidum cyst. 34 It is generally accepted that the perforation should be made on an avascular area of the septum pellucidum due to the limitation of the
Limitations of the transcallosal transchoroidal approach to the third ventricle
Technical note
Arthur J. Ulm, Antonino Russo, Erminia Albanese, Necmettin Tanriover, Carolina Martins, Robert M. Mericle, David Pincus, and Albert L. Rhoton
A pproaching lesions within the third ventricle is challenging given the deep-seated location of the area and the critical surrounding structures. Manipulating the walls of the third ventricle can cause hypothalamic dysfunction manifested as disturbances in consciousness, temperature control, respiration, and pituitary secretion. In addition, visual loss due to damage of the optic chiasm and memory loss from injury to the columns of the fornix in the walls of the third ventricle can occur. 23 The pathophysiology in the third ventricle is diverse and
