Shimizu Y, Aihara H, Fukawa O, Ishii M
No Shinkei Geka. 1985 Jan;13(1):71-6.
A rare case of epidermoid of the third ventricle was experienced. The patient was a fifteen years old boy, who had been hospitalized four years earlier due to acute hydrocephalus. The ventriculography at that time revealed a large cystic tumor containing heterogeneous mass filling the entire third ventricle, which seemed to be a dermoid or epidermoid. Ventricular drainage and ventriculo-peritoneal shunt were performed and he was discharged one month later without any complaint. On February 10th 1983, he was re-admitted with severe headache, nausea and showing markedly increased intracranial pressure and right hemianopsia. Computerized tomography scans demonstrated a large round low density mass in the entire third ventricle extending into the prepontine cistern. Radical operation was performed by the anterior transcallosal approach. After dissecting the interhemispheric fissure, a longitudinal incision about 15 mm long was made in the anterior part of the corpus callosum and the tumor was removed. Mild diabetes insipidus and subdural effusion appeared postoperatively. The patient was discharged on April 7th with right hemianopsia and returned to school. The anterior transcallosal approach seemed to be a good operative procedure in such large third ventricle tumor cases since it allowed excellent exposure of the third ventricle and minimized postoperative neurological deficits.
遇到一例罕见的第三脑室表皮样囊肿病例。患者为一名15岁男孩，四年前因急性脑积水入院。当时的脑室造影显示一个大的囊性肿瘤，其中含有异质性肿块，占据整个第三脑室，似乎是皮样囊肿或表皮样囊肿。进行了脑室引流和脑室-腹腔分流术，一个月后他出院，无任何不适。1983年2月10日，他因严重头痛、恶心再次入院，颅内压明显升高，伴有右侧偏盲。计算机断层扫描显示整个第三脑室内有一个大的圆形低密度肿块，延伸至脑桥前池。采用经胼胝体前部入路进行了根治性手术。在分离大脑半球间裂后，在胼胝体前部做了一个约15毫米长的纵切口，切除了肿瘤。术后出现轻度尿崩症和硬膜下积液。患者于4月7日出院，遗留右侧偏盲，之后重返学校。对于如此大的第三脑室肿瘤病例，经胼胝体前部入路似乎是一种很好的手术方法，因为它能很好地暴露第三脑室，并使术后神经功能缺损最小化。
