Fourth Ventricle Tumors: A Review of Series Treated With Microsurgical Technique

Abstract

Tumors of the IV ventricle represent 1–5% of all intracranial lesions; they are implicated in 2/3 of the tumors of the ventricular system. According to modern standards, the first treatment stage for this pathology is microsurgical removal. Currently, for the removal of neoplasms of the IV ventricle and brainstem, the median suboccipital approach is widely used, followed by one of the microapproaches. Moreover, with the development of microsurgical techniques, keyhole approaches are now beginning to be utilized. However, surgical treatment of these tumors remains a challenge for neurosurgeons due to the proximity of functionally important anatomical structures (the brainstem, the cerebellum, pathways, vessels, etc.) of the posterior cranial fossa. Therefore, surgery in this area is associated with the possible occurrence of a wide range of postoperative complications. The authors provide a review of series of fourth ventricle tumors treated with microsurgical technique.

Case report: Impact of mixed reality on anatomical understanding and surgical planning in a complex fourth ventricular tumor extending to the lamina quadrigemina

“…Fourth ventricular tumors account for 1%–5% of all intracranial neoplastic lesions and represent two-third of the lesions of the ventricular system ( 1 , 2 ). To date, the classical and oldest approach to removing tumors of the fourth ventricle is the median suboccipital approach, which allows access to lesions of the cerebellar hemispheres, vermis, and medulla ( 1 , 13 ). This approach is beneficial for extended anatomical exposure, enabling good surgical orientation and intraoperative manipulation.…”

“…To date, the primary therapeutic strategy for tumors of the fourth ventricle is microsurgical removal (1)(2)(3). Lesions of the fourth ventricle may present with a wide range of anatomical variations and are in close proximity with extremely eloquent structures in the context of the anatomical complexity of the posterior fossa.…”

Bruns syndrome in a patient with intraventricular subependymoma: a case report

“…The incidence of lateral ventricular tumors accounts for approximately 0.8% to 1.6% of all intracranial lesions [10]. On the other hand, tumors of the fourth ventricle represent 1-5% of all intracranial lesions [6]. The most common tumor types in both locations are ependymomas [7][8][9].…”

“…Specific symptoms of fourth ventricle tumors may include cerebellar damage, particularly ataxia, intentional tremor, cerebellar dysarthria, and dysfunction of the cranial nerves (from V to XII) [ 6 ]. However, both types of tumors may also exhibit similar symptoms such as hydrocephalus, headache, nausea, and vomiting due to blockage in the ventricles, which hinders the free flow of cerebrospinal fluid and increases intracranial pressure.…”