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Bobble-Head Doll Syndrome
Published in Alexander R. Toftness, Incredible Consequences of Brain Injury, 2023
The cause of bobble-head doll syndrome is usually traced back to a cyst in the brain located in or near the third ventricle. A cyst is like a bubble of cell tissue that isn't supposed to be there, and it can potentially form on several surfaces in the brain. The third ventricle, like all ventricles, is not actually a brain structure made up of brain cells such as neurons. Instead, it is an area located between brain structures that is filled with a liquid called cerebrospinal fluid. The third ventricle is located deep in the brain, below the corpus callosum, and between the thalami of the brain's hemispheres. Cerebrospinal fluid normally flows through this area, as the third ventricle is part of a series of connected ventricles in the brain. But because a cyst is blocking the connection between the ventricles, the flow of the cerebrospinal fluid is impaired (Hahm et al., 2018). Because of the blockage, pressure builds up in the brain, and the area of the fluid-filled third ventricle expands, resulting in pressure on the other surrounding parts of the brain (Guerreiro et al., 2012). The bobble-head doll syndrome symptoms occur because of this pressure, but exactly why this pressure causes head-bobbling is debated.
Nutritional Deficiencies
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Deepa Bhupali, Fernando D. Testai
Korsakoff's amnestic–confabulatory state: Third ventricle tumors.Temporal lobe infarction or surgical resection.Herpes simplex encephalitis.Hypoxic encephalopathy.Alzheimer's disease.
Choroid Plexus Tumors and Meningiomas
Published in David A. Walker, Giorgio Perilongo, Roger E. Taylor, Ian F. Pollack, Brain and Spinal Tumors of Childhood, 2020
Kenneth K. Wong, Elwira Szychot, Jennifer A. Cotter, Mark Krieger
CPTs present in early life when their age at presentation determines the symptomatology with rapid head growth, developmental delay, and sun-setting signs due to hydrocephalus. Once the skull bones have fused at 18 months, symptoms of raised intracranial pressure with headache and vomiting as well as sixth-nerve palsy and papilledema typically feature. The raised intracranial pressure is most commonly due to overproduction of CSF, but obstruction of CSF flow by tumor mass or subclinical bleeding that blocks CSF absorption by arachnoid granulations can occur. Tumors in the third ventricle may cause endocrine disturbances, precocious puberty, diabetes insipidus, or diencephalic disorders such as temperature or thirst dysregulation.6 Other clinical findings include focal neurologic deficits, cranial nerve palsies, seizures, and coma.7–10
The ‘worm’ in our brain. An anatomical, historical, and philological study on the vermis cerebelli
Published in Journal of the History of the Neurosciences, 2023
Third, from an anatomical standpoint, there is no pannicular-membrane at the highest part of the choroid plexus, viz. inside the third ventricle. As Galen noted, there is such a “membrane” connected intimately with the original vermis (the epiphysis vermicularis), which covers the roof of the aqueduct and the proximal part of the fourth ventricle, known today as the velum medullare anterius. Fourth, Albert and Avicenna described this membrane in almost identical words. Finally, for both Galen and Avicenna, the worm was by definition “a part of the brain” (see above), and Albert agreed: est pars cerebri. All these arguments render the interpretation of the pars vermicularis as choroid plexus highly improbable and speak in favor of one single “Galenic” worm.
Pure endoscopic resection of pineal region tumors through supracerebellar infratentorial approach with ‘head-up’ park-bench position
Published in Neurological Research, 2023
Wei Hua, Hao Xu, Xin Zhang, Guo Yu, Xiaowen Wang, Jinsen Zhang, Zhiguang Pan, Wei Zhu
SCIT approach is popular for pineal region tumor resection due to the natural corridor between the cerebellum and the tentorium [11]. The paramedian SCIT approach may be superior to the classic midline approach in terms of safety, functionality, and avoiding venous sacrifice [13,33]. The drawbacks of the midline approach are the sacrifice of the deep drainage veinous complex of the cerebellum vermis and the need for more cerebellar retraction [13]. However, the rate of GTR, tumor size, and surgical time are similar between the paramedian and midline SCIT approaches [27]. The advantage of the midline approach is to deal with those deep-seated tumors with third ventricle invasion. It would be safe and easy to identify the bilateral planes, which cannot be achieved from the ipsilateral corridor. For giant tumors or tumors with third ventricle invasion, we would recommend median SCIT approach. Since it is easier to access the posterior third ventricle by combining the midline approach with a large bone flap, especially for giant tumors. In this cohort, all tumors invading the third ventricle (cases 1, 2, and 3) achieved GTR, and the posterior third ventricle was opened during surgery with straight visualization. Endoscopy might be inappropriate for tumors larger than 3 cm in some literature [7,15]. We would agree to choose relatively small cases for safety issue, in case of uncontrolled bleeding. By utilizing CUSA and a large midline bone window, two tumors (50%) exceeding 3 cm, including one tenacious, underwent GTR without complications in our cohort. The shortcoming might therefore be the need for a larger bone flap [33].
Surgical declarative knowledge learning: concept and acceptability study
Published in Computer Assisted Surgery, 2022
A. Huaulmé, G. Dardenne, B. Labbe, M. Gelin, C. Chesneau, J. M. Diverrez, L. Riffaud, P. Jannin
Endoscopic third ventriculostomy (ETV) is a routine neurosurgical procedure mostly used to treat obstructive hydrocephalus both in children and adults. ETV offers significant advantages over shunts and is considered the gold standard in the management of non-communicating hydrocephalus. Residents in neurosurgery have to learn and master this endoscopic technique as early as possible in their surgical curriculum. ETV is divided into five phases: (1) A burr-hole is performed in the right frontal bone (Kocher’s point); (2) A rigid endoscope is introduced through the right frontal lobe into the right frontal horn of the lateral ventricle; (3) insertion of the endoscope into the third ventricle through the foramen of Monro; (4) perforation of the floor of the third ventricle. This communication between the third ventricle and the subarachnoid cisterns allows the circulation of cerebrospinal fluid trapped in the ventricles to the subarachnoid space. Finally, (5) the endoscope is removed and the skin is closed.