The third ventricle. Normal anatomy and changes in some pathological conditions

Corrales, M.; Torrealba, Gonzalo

doi:10.1007/bf00328385

Cited by 24 publications

(8 citation statements)

References 12 publications

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“…The shape of the anterior part of the third ventricle is also influenced by the intraventricular pressure 8. The anterior part (the premammillary portion) of the floor of the third ventricle consists of a very thin layer of grey matter of the hypothalamus and can protrude into the sella under high intraventricular pressure 9. The likelihood of developing this anatomical change is higher with the presence of a pressure gradient between the third ventricle and the subarachnoid space, as occurs in cases of obstructive hydrocephalus.…”

Section: Discussionmentioning

confidence: 99%

“…6 10 11 None the less the association of hydrocephalus, empty sella, and the persistence of the infidbular recess is very rare. Probably other factors such as position of the optic chiasm9 and the duration of hydrocephalus may contribute to the association of the anomalies. It is interesting that our cases were young women with LOVA and most of the other cases are elderly patients; there are no reported cases in children of hydrocephalus, empty sella, and persistence of the infundibular recess.…”

Section: Discussionmentioning

confidence: 99%

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Anatomical variants in the floor of the third ventricle; implications for endoscopic third ventriculostomy

Morota

2000

Journal of Neurology, Neurosurgery &Amp; Psychiatry

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Longstanding hydrocephalus and raised intracranial pressure can lead to unusual anatomical variants in the floor of the third ventricle, which may be important when performing endoscopic third ventriculostomy. Two middle aged patients with symptomatic longstanding hydrocephalus had scans that showed ventricular hydrocephalus, an empty sella, and a dilated infundibular recess which herniated into the sella turcica. Endoscopic third ventriculostomy confirmed that instead of the tuber cinerum and infundibular recess, the anterior inferior floor of the third ventricle was hanging down ventral to the pons into the sellar floor. Third ventriculostomy to the prepontine cistern was made on the dorsal wall of the dilated infundibular recess to the area surrounded by the dorsum sellae, the basilar artery trunk, and the left superior cerebellar artery, with good symptomatic control. Association of the empty sella and persistence of the infundibular recess must be carefully evaluated by MRI before attempting endoscopic third ventriculostomy. Herniation of the anterior inferior floor of the third ventricle into the empty sella can lead to loss of anatomical landmarks that require special attention during third ventriculostomy. (J Neurol Neurosurg Psychiatry 2000;69:531-534) Keywords: hydrocephalus; endoscopy; third ventriculostomy Endoscopic third ventriculostomy plays an important part in the treatment of hydrocephalus.1 Anatomical landmarks are well established and the procedure is safe in well experienced hands. Recently we have encountered two adult patients who were diagnosed as "long standing overt hydrocephalus in the adult (LOVA)" 2 and in whom the floor of the third ventricule was seen to be completely diVerent from the normal anatomy. We report the cases and surgical techniques, and discuss the relation between hydrocephalus, empty sella, and persistence of infundibular recess which were associated with the patients. CASE 1 A 31 year old woman had had chronic headaches, which increased in frequency and were accompanied by dizziness. Brain CT showed marked ventriculogmegaly with flat- Case report

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Anatomical variants in the floor of the third ventricle; implications for endoscopic third ventriculostomy

Morota

2000

Journal of Neurology, Neurosurgery &Amp; Psychiatry

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“…3E and F) may not actually represent PEIR and seem to be very similar to other radiological reports of the typical finding in cases of hydrocephalus coincidental with empty sella. 3,7 Careful review of the diagnosis accompanying the articles support the impression that increased intraventricular pressure and hydrocephalus caused dilation of a previously normal infundibular recess with its herniation into the primary empty sella. In previous publications 1, 6,9,11,13,15 different terms for PEIR, such as "persistence of infundibularis recessus" or "dilated infundibular recessus" were used.…”

Section: Discussionmentioning

confidence: 91%

Persisting embryonal infundibular recess

Šteňo

Wolfsberger

et al. 2009

JNS

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Persisting embryonal infundibular recess (PEIR) is a rare anomaly of the third ventricular floor that has an unclear pathogenesis. In all 7 previously described cases, PEIR was present in adult patients and was invariably associated with hydrocephalus and, in 4 reported cases, with an empty sella. These associated findings led to speculations about the role of increased intraventricular pressure in the development of PEIR. In the present case, PEIR was found in a 24-year-old man without the presence of hydrocephalus or empty sella. Disorders of pituitary function had been present since childhood. Magnetic resonance imaging revealed a cystic expansion in an enlarged sella turcica. A communication between the third ventricle and the sellar cyst was suspected but not apparent. During transcranial surgery, the connection was confirmed. Later, higher-quality MR imaging investigations clearly showed a communication between the third ventricle and the sellar cyst through a channel in the tubular pituitary stalk. This observation and knowledge about the embryology of this region suggests that PEIR may be a developmental anomaly caused by failure of obliteration of the distal part of primary embryonal diencephalic evagination. Thus, PEIR is an extension of the third ventricular cavity into the sella. Although PEIR is a rare anomaly, it is important to identify when planning a procedure on cystic lesions of the sella. Because attempts at removal using the transsphenoidal approach would lead to a communication between the third ventricle and the nasal cavity, a watertight reconstruction of the sellar floor is necessary.

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“…The tuber cinereum is the place to perform ETV. This procedure could be easily done when the tuber cinereum is wide and translucent [1,4,6,8,9]. In some cases it is opaque with different anatomical variations [3,12].…”

Section: Discussionmentioning

confidence: 99%