Diagnosis and Surgical Treatment of Fourth Ventricle Tumors

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  • 第四脳室 (近傍) 腫瘍の診断と手術

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<p>  Fourth ventricle tumors are generally classified into two groups from the point of view of benign or malignant nature, or pediatric or adult tumors. But based on a surgical perspective, it is more important to classify whether the tumor is a true fourth ventricle tumor or not. Ependymomas, hemangioblastomas and choroid plexus papillomas are representative true fourth ventricle tumors. On the other hand, medulloblastomas and pilocytic astrocytomas are tumors that originate from the surrounding cerebellar hemisphere or cerebellar vermis, which extend to the fourth ventricle. In surgery of true fourth ventricle tumors, the cerebello-medullary fissure approach including the incision of the taenia and wide opening of the tela choroidea is effective in exposing both the tumor and the fourth ventricle floor. However, for medulloblastoma resection, using the uvulo-tonsillar space without dissection of the cerebello-medullary fissure is often effective. Key anatomical landmarks for surgery near the fourth ventricle are the inferior velum and the tela choroidea.</p><p>  In this manuscript, we present typical MRI findings of fourth ventricle tumors and our surgical procedures.</p>

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