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Ivar Szper, Shizuo Oi, Jan Leestma, Kwan Soo Kim, and Nicholas E. Wetzel

L esions that are localized completely within the third ventricle are rare entities, accounting for only 6% of all cerebral tumors. 11 Clinically, they give rise to a ventricular syndrome and their neuroradiological diagnosis is difficult. Pathologically, most lesions of the third ventricle are neoplastic, or have a hamartomatous or developmental character. We are presenting a case that illustrates the diagnosis and treatment of one such tumor which was not a neoplasm, but rather a mass lesion probably produced by degeneration or an aging phenomenon. Case

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John M. Abrahams, Mark S. Forman, Ehud Lavi, Herbert Goldberg, and Eugene S. Flamm

radiographic and histological similarities between meningiomas and HPCs, the determining factor relies on the pathological diagnosis. 7, 9, 11, 13, 18 We report the first case of an HPC occurring in the anterior third ventricle. Muttaqin and associates 17 reported the only other case of an intraventricular HPC; that lesion was found in the trigone of the lateral ventricle. Case Report This 40-year-old right-handed man was referred to our institution after complaining of a 3-month history of headaches that intermittently worsened. Initially, the headaches presented as quite

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Marvin Bergsneider, John G. Frazee, and Antonio A. DeSalles

intraventricular hemorrhage of a saccular aneurysm lying within the third ventricle. Case Report This 65-year-old, right-handed man presented with a sudden onset of severe headache, a stiff neck, photophobia, and emesis. His medical history was significant for long-standing hypertension and moderate alcohol-related liver disease with resultant coagulopathy, chronic anemia, and thrombocytopenia (prothrombin time 16.2 seconds (control 12.1 seconds); hematocrit 32.2; platelet count 76,000/cu mm). He had a distant history of syphilis, but no evidence of meningovascular disease

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B. K. Kleinschmidt-DeMasters, Ken R. Winston, David Rubinstein, and Mary H. Samuels

P ituitary adenomas occur only rarely in extrasellar sites that are not in continuity with the pituitary. Such sites have included the sphenoid sinus, 8 nasal cavity, 3, 10 petrous temporal bone, 10 and third ventricle. 11 Ectopic growth has been reported in patients with a separate intrasellar pituitary adenoma, suggesting that the ectopic growth arose from dissemination of a primary intrasellar tumor, either spontaneously or following surgical manipulation. 9, 10 In the very rare situation where ectopic pituitary adenomas have been identified without

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John R. Little and Collin S. MacCarty

C olloid cysts of the third ventricle are relatively rare, representing less than 1% of all intracranial tumors. 8 They are of special interest because they are benign and can be removed completely. Wallmann (1858) 18 was the first to report a case with a colloid cyst of the third ventricle. Sjöval 16 postulated that this tumor was derived from the paraphysis, an embryonic structure in the rostral portion of the roof of the third ventricle. Dandy performed the first successful removal of a colloid cyst in 1921 using the pineal approach. 5 In his monograph

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Colloid cyst of the third ventricle

A scanning and transmission electron microscopic study

Richard W. Leech, Thomas Freeman, and Robert Johnson

C olloid cysts of the third ventricle are rare tumors of the central nervous system (CNS), and represent one of a variety of epithelial-lined cysts of the neuraxis with a relatively simple epithelium and a highly debatable origin. Morphological analyses, in particular more recent electron microscopic studies, have offered possible origins that fall into two large categories. They are: 1) neuroepithelium, including the paraphysis, ependyma, choroid plexus, and tela choroidea; and 2) endoderm, including primitive respiratory and enteric epithelium. To date, the

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Surgical resection of third ventricle colloid cysts

Preliminary results comparing transcallosal microsurgery with endoscopy

Adam I. Lewis, Kerry R. Crone, Jamal Taha, Harry R. van Loveren, Hwa-Shain Yeh, and John M. Tew Jr.

C olloid cysts are benign intraventricular tumors that arise primarily from the roof of the third ventricle and may produce sudden death due to acute obstruction of cerebrospinal fluid (CSF) pathways. Most patients present with headaches due to raised intracranial pressure and hydrocephalus. Associated symptoms include short-term memory loss, nausea and vomiting, blurred vision, emotional lability, and gait disturbances. Present management options for colloid cysts include observation, shunting of CSF, stereotactic cyst aspiration, transcortical

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Theodore G. Obenchain and Donald P. Becker

angiograms showed marked elevation and bowing of the internal cerebral veins and changes consistent with hydrocephalus. Opening pressure on spinal tap was 340 mm H 2 O; spinal fluid protein was 71 mg. Ventriculography revealed air in the posterior third ventricle outlining a soft tissue mass within it ( Fig. 1 ). The cyst was filled with air from the basal and chiasmatic cisterns by pneumoencephalography ( Fig. 1 ). Following the air study the patient was hypokinetic, lying in bed nearly motionless. Fig. 1. Left: Ventriculogram lateral view, showing dilated

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Thomas M. Markwalder, Regula V. Markwalder, and Hans M. Markwalder

the third ventricle are extremely rare. The latter tumors are mostly located in the posterior part of the third ventricle and present a symptomatology resembling pinealomas. 5 This paper presents a case of meningioma of the anterior part of the third ventricle. Case Report This 36-year-old woman was seen in neurosurgical consultation in December, 1973, because of amenorrhea. Six months later she presented with a marked ataxia, dysdiadochokinesia, and kinetic tremor of both hands, followed by signs of raised intracranial pressure (ICP). Examination

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Mark M. Souweidane, Caitlin E. Hoffman, and Theodore H. Schwartz

endoscopic third ventricular surgery. How these variants affect the surgical technique of ETV or endoscopic colloid cyst resection has hitherto not been defined. Recent experience in patients with a cystic variant of the septum pellucidum who underwent either ETV or endoscopic colloid cyst resection has afforded us the opportunity to detail the germane intraventricular anatomy and make recommendations with respect to a safe endoscopic approach into the third ventricle. Methods Patients were selected from a prospective database maintained by the first author (M