Costa J M, Ley L, Claramunt E, Lafuente J
Department of Neurosurgery, University Hospital Sant Joan de Deu, Barcelona, Spain.
Childs Nerv Syst. 1997 May;13(5):244-9. doi: 10.1007/s003810050077.
The III ventricle is an uncommon location for choroid plexus papilloma at any age. We describe three new cases of choroid plexus papillomas of the III ventricle (CPPs). All children were boys under 4 months of age and all presented with increased intracranial pressure, hydrocephalus and macrocephaly. The three were examined by preoperative computed tomography (CT) and ultrasonography. Two of them were investigated with magnetic resonance imaging (MRI). The first case was treated with a right corticofrontal transventricular approach and subtotal resection, so that he required a second operation through a transcallosal approach. In the other two cases a transcallosal approach was used. Two children needed permanent ventriculo-peritoneal shunts. The average follow-up of 4.3 years has revealed no neurological deficits in any case. The timing of and the need for shunting are major considerations. Clinical and imaging follow-up (CT and/or ultrasonography) are very helpful in controlling postoperative hydrocephalus and subdural effusion, avoiding unnecessary shunting in many cases. The operative approaches, transcortical and transcallosal, are discussed.
第三脑室是脉络丛乳头状瘤在任何年龄段都不常见的发病部位。我们描述了3例第三脑室脉络丛乳头状瘤（CPPs）的新病例。所有患儿均为4个月以下男婴，均表现为颅内压升高、脑积水和巨头畸形。3例患儿术前均接受了计算机断层扫描（CT）和超声检查。其中2例还接受了磁共振成像（MRI）检查。第1例采用右额皮质经脑室入路行次全切除术，因此需要通过经胼胝体入路进行二次手术。另外2例采用经胼胝体入路。2例患儿需要永久性脑室-腹腔分流术。平均4.3年的随访显示，所有病例均无神经功能缺损。分流的时机和必要性是主要考虑因素。临床及影像学随访（CT和/或超声）对控制术后脑积水和硬膜下积液非常有帮助，在很多情况下可避免不必要的分流。文中讨论了经皮质和经胼胝体的手术入路。
