Huh Ji Soon, Hwang Yong Soon, Yoon Soo Han, Cho Ki Hong, Shin Yong Sam
Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, South Korea.
Pediatr Neurosurg. 2007;43(2):115-20. doi: 10.1159/000098384.
A ventricular diverticulum is usually found in patients with long-standing severe obstructive hydrocephalus that may extend into the supracerebellar cistern. The route involved in the supracerebellar extension of the ventricular diverticulum is believed to originate through the tela choroidea of the temporal choroid plexus or of the antral choroid plexus. The authors report a 4-week-old girl with hydrocephalus as a result of unilateral obstruction of the foramen of Monro, which dilated the right ventricle and displaced the midline to the left side, collapsing the contralateral lateral ventricle. The dilated lateral ventricular diverticulum herniated to the supracerebellar cistern in the posterior fossa that compressed the cerebellum inferiorly. She was treated successfully by a ventriculoperitoneal shunt, resulting in a marked reduction of the ventricle and diverticulum on the follow-up computed tomography and magnetic resonance imaging. We reviewed the literature for the supracerebellar extension route of ventricular diverticulum and suggest that the medial choroidal fissure in the antrum and the velum interpositum may be important anatomical structures for the extension of the lateral ventricular diverticulum into the supracerebellar cistern.
脑室憩室通常见于患有长期严重梗阻性脑积水的患者,脑积水可能延伸至小脑上池。脑室憩室向小脑上池延伸所涉及的路径被认为起源于颞叶脉络丛或颞角脉络丛的脉络膜。作者报告了一名4周大的女孩,因Monro孔单侧梗阻导致脑积水,这使右心室扩张并使中线向左移位,对侧侧脑室塌陷。扩张的侧脑室憩室疝入后颅窝的小脑上池,向下压迫小脑。她通过脑室腹腔分流术成功治疗,在后续的计算机断层扫描和磁共振成像中,脑室和憩室明显缩小。我们回顾了有关脑室憩室向小脑上池延伸路径的文献,并提出颞角的内侧脉络膜裂和中间帆可能是侧脑室憩室延伸至小脑上池的重要解剖结构。