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Anatomy for neurotrauma
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Anesthesia for Neurotrauma, 2018
Vasudha Singhal, Sarabpreet Singh
The system comprises of four ventricles—lateral ventricles (right and left), third ventricle, and fourth ventricle. The interventricular foramina of Monro connect each lateral ventricle to the third ventricle, located between the right and left thalamus. The third ventricle opens into the fourth ventricle located behind the pons and upper half of medulla, via the aqueduct of Sylvius. The fourth ventricle then communicates with the subarachnoid space via the median aperture of Magendie, and two lateral apertures of Luschka. The CSF then flows around the cerebral hemispheres, and are reabsorbed by the arachnoid villi into the venous sinuses, finally draining into the internal jugular vein. CSF provides buoyancy and support to the brain against gravity, protecting it from concussive, injury to a great extent.
Benign ependymoma with extensive intracranial and spinal cerebrospinal fluid dissemination: case report and literature review
Published in British Journal of Neurosurgery, 2019
Fangmei Zhu, Jurong Ding, Yumei Li, Dewang Mao, Xianglei He, Wanyuan Chen, Lin Lou, Zhongxiang Ding
The first craniotomy was performed to remove the mass at the fourth ventricle. The tumor appeared as a soft, and moderately vascularized mass in the median aperture of the fourth ventricle. And subtotal resection of the primary lesion and the nodules on the surface of the meninges was achieved at the same time. A further lumbar laminectomy was performed to remove the tumor of the lumbosacral intraspinal canal two months after the first operation. A brittle tumor with an obscure boundary was intraoperatively found to be closely attached to the cauda equina and filum terminale. The tumor was separated and carefully removed, but a small portion of the tumor could not be resected for the sake of preserving nerve function.