Mizoguchi M, Inamura T, Hikita T, Cheng C L, Ohgami S
Hamanomachi Hospital, Fukuoka, Japan.
Minim Invasive Neurosurg. 2000 Mar;43(1):53-5. doi: 10.1055/s-2000-8414.
A type of intrinsic dorsal midbrain glioma known as benign tectal glioma can cause obstructive hydrocephalus. Because of its slow progress and relatively good prognosis, initial treatment should be cerebrospinal fluid diversion and biopsy.
We report a 24-year-old man with obstructive hydrocephalus from a tectal glioma, who was admitted to the hospital for malfunction of a shunt placed 16 years previously.
Magnetic resonance imaging demonstrated enlargement of the dorsal midbrain associated with increased signal intensity on T2-weighted images and fluid attenuation inversion recovery (FLAIR) images. No enhancement occurred with contrast administration. We performed a neuroendoscopic third ventriculostomy and biopsy of the tumor. Histologic examination of the specimen obtained disclosed a low-grade astrocytoma. No postoperative neurologic complications occurred.
FLAIR images were superior to T2-weighted images in demonstrating abnormal intensity in the dorsal midbrain. Neuroendoscopy confirmed a yellowish tumor inferior to the posterior commissure occluding the entrance of the aqueduct, an observation useful in planning biopsy of the lesion. As the tumor apparently had existed for a number of years, the case supports the notion that the prognosis associated with these tumors is good.
一种称为良性顶盖胶质瘤的脑室内背侧中脑胶质瘤可导致梗阻性脑积水。因其进展缓慢且预后相对较好，初始治疗应为脑脊液分流和活检。
我们报告一名24岁男性，因顶盖胶质瘤导致梗阻性脑积水，因16年前放置的分流器故障入院。
磁共振成像显示背侧中脑增大，T2加权像和液体衰减反转恢复（FLAIR）像上信号强度增加。增强扫描未见强化。我们进行了神经内镜下第三脑室造瘘术及肿瘤活检。对获取的标本进行组织学检查显示为低级别星形细胞瘤。术后未发生神经并发症。
在显示背侧中脑异常信号强度方面，FLAIR像优于T2加权像。神经内镜证实后连合下方有一黄色肿瘤阻塞导水管入口，这一观察结果有助于规划病变的活检。由于该肿瘤显然已存在数年，该病例支持这些肿瘤预后良好的观点。
