Le Gars D, Lejeune J, Desenclos C
Service de Neurochirurgie, Hôpital Nord, CHU, place Victor-Pauchet, 80054 Amiens Cedex 1.
Neurochirurgie. 2000 Jun;46(3):296-319.
In this chapter, the authors compared the results of the national series (262 patients) with the relevant data from the literature, in order to establish the optimal therapeutic management. Colloid cysts represent the main tumor encountered within the third ventricle (145 cases). Sudden death from colloid cysts is documented in this series, but neurosurgeons should also be aware of the increasing number of fortuitous diagnosis of such lesions. The liquid consistency of the content of the cyst is the major argument to choose the surgical procedure. Liquid colloid cysts usually associate isodense appearance on CT Scan, hypo-intensity on T1 weighted MRI images, and hyperintensity on T2-weighted MRI images. Endoscopy now appears as an accurate surgical procedure. A surgical strategy is proposed. Among glial tumors, pilocytic astrocytomas are poorly documented in the literature. Low grade astrocytomas, ependymomas, subependymomas and giant cell subependymal astrocytomas, gangliogliomas, and oligodendrogliomas were reviewed with the relevant literature. Other tumors are rare in the third ventricle, except for choroid plexus papilloma and craniopharyngioma. The reality of purely intraventricular craniopharyngioma is confirmed by the experience of this series. Other lesions such as meningioma, cavernoma, germ-cell tumors, lymphomas, metastasis, epidermoid cysts, and exceptionnal lesions were also reviewed.
在本章中，作者将全国性系列研究（262例患者）的结果与文献中的相关数据进行了比较，以确定最佳治疗方案。胶样囊肿是第三脑室内最常见的肿瘤（145例）。本系列研究记录了因胶样囊肿导致的猝死情况，但神经外科医生也应意识到此类病变偶然诊断的数量在增加。囊肿内容物的液体状态是选择手术方式的主要依据。液体性胶样囊肿在CT扫描上通常表现为等密度，在T1加权磁共振成像（MRI）图像上呈低信号，在T2加权MRI图像上呈高信号。如今，内镜检查已成为一种精确的手术方法。本文提出了一种手术策略。在胶质肿瘤中，文献中对毛细胞型星形细胞瘤的记载较少。对低级别星形细胞瘤、室管膜瘤、室管膜下瘤、巨细胞室管膜下星形细胞瘤、神经节胶质瘤和少突胶质细胞瘤进行了文献综述。除脉络丛乳头状瘤和颅咽管瘤外，其他肿瘤在第三脑室中较为罕见。本系列研究的经验证实了单纯脑室内颅咽管瘤的存在。还对其他病变，如脑膜瘤、海绵状血管瘤、生殖细胞肿瘤、淋巴瘤、转移瘤、表皮样囊肿及罕见病变进行了综述。
