Faculty Bibliography

Tumors located in the region of the foramen of Monro often present with signs and symptoms of obstructive hydrocephalus. Various types of lesions occur in this location. We describe a case of a dysembryoplastic neuroepithelial tumor of the septum pellucidum presenting with obstructive hydrocephalus and its successful endoscopic excision. The surgical considerations and pathologic findings are discussed

BACKGROUND: An isolated or trapped fourth ventricle (TFV) is an occasional, serious sequela of hemorrhagic, infectious, or inflammatory conditions of the central nervous system. The TFV usually occurs after successful shunting of the lateral ventricles. It may be heralded by delayed clinical deterioration after an initial period of symptomatic improvement. The typical clinical findings suggest an expanding posterior fossa mass lesion. Surgical treatments include CSF diversionary procedures as well as open and endoscopic approaches. Complications related to the treatment of the TFV are common and relate to catheter obstruction and cranial nerve or brainstem dysfunction. METHODS: The author reviews the clinical features, pathophysiology, and available treatment options for the TFV, with special reference to complication avoidance and advances in ventriculoscopy and frameless stereotaxy. CONCLUSIONS: Treatment of the TFV remains a formidable challenge. However, prompt recognition and intervention may aid in the preservation of life and neurological function

BACKGROUND: Growing skull fractures and other enlarging skull defects are rare postoperative occurrences. We report here on a 10-month-old girl who presented with an enlarging burr hole and pseudomeningocele after an endoscopic third ventriculocisternostomy. METHODS: Evaluation of an enlarging subcutaneous mass at the site of the burr hole included computed tomography scans and magnetic resonance imaging, which revealed a pseudomeningocele. The patient underwent repair of the lesion, including dural closure and cranioplasty. CONCLUSIONS: Growing skull fractures or other enlarging bone defects may occur after burr hole placement, particularly in infants who require larger access sites for endoscopy