Lateral ventricle tumor

Introduction to lateral ventricle tumor There is one on each side of the lateral ventricle, the shape is irregular, and it is located in the frontal, parietal, occipital and temporal lobes. It is divided into five parts: anterior horn, lower horn, posterior horn, body and triangle. It contains cerebrospinal fluid, which is secreted from the choroidal tissue in the lateral ventricle. The lateral cerebral tumor refers to the lateral ventricular wall, choroidal tissue and ectopic Tissue tumors. Meningiomas, ependymoma, choroidal papilloma and epithelioid cysts are common, of which meningioma is the most common. According to the statistics of a large number of cases, the anterior part of the lateral ventricle is more common in glioma, and the posterior part is more common. Tumors, choroidal papilloma often occur in the triangle, and can extend to other parts of the ventricle, sometimes through the interventricular pores into the third ventricle. However, it seems that the lateral ventricle tumors occur mostly in the anterior and triangular regions of the lateral ventricle. They can be seen at any age, but there are more cases before the age of 20, and the left side seems to be more than the right side, more male than female. basic knowledge The proportion of illness: 0.0005%-0.0007% Susceptible people: no specific people Mode of infection: non-infectious Complications: hydrocephalus cerebral palsy

Lateral ventricle tumor etiology

The cause of the disease is unknown, speculation may be related to physical factors, such as radiation; psychosocial factors, such as nervousness, anxiety, etc.; genetic and traumatic factors.

Lateral ventricle tumor prevention

Mainly for the prevention of the cause, no other effective preventive measures, for early detection, early diagnosis, early treatment.

Lateral ventricle tumor complications Complications hydrocephalus cerebral palsy

Oppression, transfer to other parts and even death.

Symptoms of lateral ventricle tumors Common symptoms Coma hydrocephalus sensory disorder Nausea cerebral palsy Before the eyes, black mental disorder, slow response, inability to hemianopia

The ventricle is a cavity in the brain containing cerebrospinal fluid, so its clinical manifestation depends on the size and location of the tumor. Only when the tumor blocks the cerebrospinal fluid circulation pathway, or when the tumor oppresses the surrounding brain tissue, the corresponding symptoms and signs appear. Such as increased intracranial pressure and focal symptoms.

1. Increased intracranial pressure;

When the tumor in the lateral ventricle is small or does not cause cerebrospinal fluid circulation, the patient may have no obvious symptoms at all. When the cerebrospinal fluid circulation disorder occurs (interventricular occlusion, partial ventricle obstruction), and intracranial hypertension occurs, Clinically, it is a headache. Headache is also the first symptom of most patients. According to statistics, 92.5% of patients with lateral ventricle tumors are the first symptom of headache. The headache is often episode, intermittent or paroxysmal aggravation. When the interventricular space or a part of the ventricle (upper or lower corner) is blocked, it causes obstructive hydrocephalus. Due to the rapid expansion of the ventricle, the patient's headache is often unbearable. When the headache is severe, the patient has nausea and vomiting. Some patients It can cause cerebral palsy to cause coma or even death due to sudden increase of intracranial pressure. The tumor has a certain degree of activity in the lateral chamber, often showing a flap and suddenly blocking the cerebrospinal fluid circulation pathway, causing an increase in acute intracranial pressure, which is also a paroxysmal headache. The cause is that when the ventricle is blocked due to changes in body position or head position, the patient's headache can be stopped quickly, such as blocking again, with Headache again, and so can be repeated multiple episodes, so there are often small number of patients in each episode before the collision or the amount of the knees were prone position.

The patient often has tonic spasm or death due to cerebral palsy when the headache is severe. Because of the long-term increase in intracranial pressure, the patient may have vision loss, and the child may have a head enlargement, which is a "breaking pot sound."

2. focal symptoms;

Focal symptoms, or localized signs, do not produce any localized signs when the tumor volume is small and uncompressed or does not invade the surrounding brain tissue. Due to the continuous growth of the tumor, the surrounding brain structures of different parts are compressed or destroyed. Different symptoms and signs of brain damage, the tumor may involve the internal capsule, the basal ganglia, and may also grow into the brain parenchyma, so that the patient has a hemiplegia or a single limb type of sputum and sensory disturbance, and the central facial paralysis with a lighter side of the lesion. , isotropic hemianopia, etc., if the left iliac crest, the top, the occipital junction area is violated, the patient will have aphasia and aphasia, and the severity of the clinical symptoms caused by the involvement of the surrounding tissue around the ventricle often varies with intracranial pressure. Changes, when the intracranial pressure is severely elevated, the symptoms become obvious, and the intracranial pressure can be temporarily relieved when the intracranial pressure drops.

3. Mental disorders;

Patients with increased intracranial pressure have different degrees of psychiatric symptoms, and the general symptoms are relatively mild. In clinical manifestations, the memory is reduced, the body is weak and weak, and the surrounding response is slow and the spirit is wilting.

4. Optic nerve head changes;

In the early stage of increased intracranial pressure, the patient presented with optic nerve head water, showing the unclear boundary of the optic nerve head, the disappearance of the physiological depression, sometimes visible radial small blood vessels, flaky villus-like vascular mass and venous fluctuations, late It is characterized by secondary optic atrophy, the patient's vision loss or even blindness, which is the result of long-term increased intracranial pressure. Patients often have a transient black sputum before the vision loss, that is, paroxysmal blackening of the eyes. This is a signal that vision loss will occur.

5. Seizures;

A small number of patients with lateral ventricle tumors may have seizures, which are generally thought to be caused by increased intracranial pressure. In clinical manifestations, they are characterized by a large seizure, a transient tonic seizure, and no localization significance.

Examination of lateral ventricle tumors

1. Cerebrospinal fluid examination patients with elevated cerebrospinal fluid pressure, cerebrospinal fluid protein content also increased, and the intraventricular room is the highest, the waist wearer has lower protein content, the tumor side of the cerebral cerebrospinal fluid protein content is higher than the contralateral side ventricle The amount of cerebrospinal fluid protein in the cerebrospinal fluid is slightly increased, and tumor cells can sometimes be found.

2. Skull X-ray plain film is a simple examination method for lateral ventricle tumor. The X-ray signs are manifested in two aspects: 1 increased intracranial pressure: increased intracranial plate index; saddle bone The quality changes, after the bed bones absorb or even disappear, the saddle back becomes shorter, and the saddle back disappears in severe cases; the intracranial pressure increases for a long time, the bone bone is absorbed and shrinks and thins; 2 tumor calcification: tumor calcification is also called For intracranial pathological calcification, lateral cerebral tumor calcification is not uncommon. It is more common in ependymoma and choroid plexus papilloma. The calcification of ependymoma is mostly caused by scattered spots in the lateral cerebral ventricle. Spherical calcification, choroid plexus papilloma mostly occurs in the lateral ventricle three regions, its calcification is characterized by calcification in the unilateral lateral ventricle, and calcification in the bilateral lateral ventricle triangle is greater than that of the normal choroid plexus. The calcification of meningiomas is mostly punctate, flaky, acicular or radial.

3. Cerebral angiography Lateral ventricle tumors mainly show vascular signs of hydrocephalus in cerebral angiography, which is characterized by the anterior cerebral artery being straightened or displaced to the contralateral side. The lateral fissure arteries may have a slight outward shift or only There is a trend of external migration, the horizontal segment of the middle cerebral artery and its branches are curved upward, the periorbital artery is moved upward, the knee is rounded, the upper segment is straightened, and the choroidal artery is straightened or displaced downward. Or an enlarged choroidal artery can be seen leading to the tumor area, sometimes showing abnormal vascular masses in the ventricles.

4. Ventricular ventriculography is a special examination method for lateral ventricle tumors, which can directly display the size and location of the tumor, and make a positioning or even qualitative diagnosis. Because the lateral ventricle tumor is easy to block the interventricular pores, the ventricle enlargement can be seen during angiography. The tumor side is obvious, and the filling defect and tumor shadow can be seen in the ventricle. The gas cerebral angiography of the lateral ventricle triangle area can be seen as a gas-enveloped mass, and sometimes the lateral ventricle is displaced to the opposite side.

5. Other EEG examinations can be seen with focal slow waves. Ultrasound examination has midline wave shift. Brain CT examination for the diagnosis of lateral ventricle tumors may indicate an important basis and may show the size, shape and location of the tumor, sometimes A qualitative diagnosis can be made.

Diagnosis and diagnosis of lateral ventricle tumor

The results of the lateral ventricle tumors are not difficult to diagnose according to their special clinical manifestations and auxiliary examinations, but they are easily confused with the following diseases and need to be identified.

(1) The third ventricle tumor The third ventricle tumor often has headache as the first symptom, and the headache is episode. This is caused by the sudden blockage of the cerebrospinal fluid circulation pathway, which can suddenly occur. When the obstruction is relieved, the headache can be relieved or disappeared. It is closely related to the change of the head position. It is generally relieved when lying down, and the headache is aggravated when lying on the back. The third ventricle tumor is often accompanied by symptoms of damage in the lower part of the hypothalamus. It is characterized by diabetes insipidus, obesity, lethargy, etc. A third ventricle filling defect is shown to confirm the diagnosis.

(B) the fourth ventricle tumor fourth ventricle tumor increased intracranial pressure and local signs are generally rare, the clinical manifestations are mostly a combination of headache, dizziness and vomiting, which is caused by increased intracranial pressure, followed by visible Local lesion symptoms, the bottom of the fourth ventricle is adjacent to multiple cranial nerve nuclei. When the tumor is compressed or invades these cranial nerve nuclei, symptoms of cranial nerve damage can occur. Patients may have tinnitus, hearing loss, difficulty swallowing, and sound. Deaf-mute, lingual muscle movement and extraocular muscle paralysis, etc., occipital foramen magnum is also more common, in patients with clinical manifestations of forced position, in addition, patients may also have cerebellar damage symptoms, manifested as unstable walking And easy to dump, the patient's optic nerve head edema, nystagmus, ventriculography found that the fourth ventricle filling defect and tumor tissue shadow can be confirmed.

(C) craniopharyngioma craniopharyngioma is a residual tumor of the embryo, derived from the residual epithelial cells of the craniopharyngioma, mostly in children, which mainly grow in the saddle and saddle, rarely occur in the sphenoid sinus Both the saddle and the saddle can be developed upwards. Some patients can protrude into the third ventricle or even the lateral ventricle. In children, the intracranial pressure is increased as the first symptom, and the clinical manifestation is headache, nausea and vomiting. And often appear neck stiffness, neck pain and double vision, tumor growth and oppression of visual conduction pathways cause vision and visual field changes, more common in adults, whether children or adults have endocrine function disorders, clinical performance For sexual dysfunction, growth retardation, water and fat metabolism disorders, visual field defects are more common in bilateral hemianopia, craniopharyngioma in the three ventricles, patients do not appear visual and visual field changes, typical craniopharyngioma The X-ray film of the skull showed signs of increased intracranial pressure. The saddle or saddle showed a little calcification and could be combined into a piece. The saddle was expanded in a spherical or pelvic shape.

(4) Hydrocephalus hydrocephalus can be divided into two types: congenital hydrocephalus and hydrocephalus caused by acquired diseases.

1. Congenital hydrocephalus Congenital hydrocephalus is caused by congenital malformations in infants and young children. The causes can be divided into three aspects: 1 middle cerebral aqueduct malformation, common in the bifurcation and stenosis of the aqueduct Secondly, the midbrain aqueduct aponeurosis can be seen; 2 Arnold-Jiaru malformation: cerebellar tonsil, medullary and fourth ventricle into the occipital foramen or spinal canal obstruction of cerebrospinal fluid circulation; 3 fourth ventricle mesial and lateral hole atresia, Congenital hydrocephalus is also called obstructive hydrocephalus due to the midbrain aqueduct or the fourth ventricle and the lateral ventricle atresia.

2. Hydrocephalus caused by acquired hydrocephalus caused by acquired diseases: meningeal infection, subarachnoid hemorrhage and brain parasitic diseases.

Infants with hydrocephalus continue to grow and sag, the forehead is prominent, the eyeball is under the eye, the sclera is exposed, the cranial suture is separated, the anterior sacral door is large and bulging, and the sputum is "breaking pot sound", the child has nausea and vomiting at the same time, intelligence Low, vision loss and blindness, some children with meningocele or spina bifida, adults only show headache, nausea and vomiting, optic nerve head edema and other symptoms of increased intracranial pressure without head enlargement; ventricle or gas brain Contrast showed an enlargement of the ventricular system.

(5) Cerebral cysticercosis, which is a guinea cytoplasmic disease of the ventricular system, mostly in a single occurrence. The larger volume is in the cerebral ventricle, and there is also a granule in the ventricle. If it blocks the midbrain aqueduct, the fourth ventricle The hole, or the above structure, inflammation and adhesion will produce obstructive hydrocephalus, and cysticercosis in the brain pool is prone to rupture, forming grape-like worms accumulating in the brain pool, and causing arachnoid hypertrophy and adhesion may also occur. Hydrocephalus, clinically, patients have headache, vomiting, increased intracranial pressure symptoms, sometimes patients lose consciousness, some patients due to cystic rupture, cystic fluid stimulation of the brain produces meningeal irritation, cerebral cysticercosis can also be multiple, Not only in the ventricle, but also in the brain tissue, due to its damage to the brain tissue, the corresponding focal symptoms, seizures in about 80% of patients, and patients often have subcutaneous nodules, excisional biopsy can confirm Fecal plaques and eggs are often found in stool examinations. The protein content of cerebrospinal fluid is increased, and the complement fixation test is positive. Ventricular angiography shows that the ventricular system of the above part is obstructed. Consistency expand and cysticercosis visible shadow.

(6) The transparent septum is a thin film between the left and right ventricles. In addition, the tumors are more common in oligodendroglioma, followed by ependymoma, glioblastoma and astrocytoma. % occurs in adults aged 20 to 40 years old. Some patients have disturbances of consciousness and forced head position. For example, patients with tumors invading the frontal and corpus callosum may have psychiatric symptoms, central facial paralysis, etc., because the tumor is located in the ventricle, the patient's skull Increased pressure, increased protein content of cerebrospinal fluid, a few cases of abnormal calcification on the X-ray film of the skull, ventricle and gas cerebral angiography showed tumor lesions of the lateral ventricle filling defect, brain CT examination can make a definite diagnosis.

(7) The clinical manifestations of thalamic tumors are mainly the two aspects of increased intracranial pressure and local damage symptoms. The increase of intracranial pressure is caused by tumor compression aqueduct, interventricular space or third ventricle. The patient has headache, nausea and vomiting. Optic nerve head edema, lesions on the opposite side of the body movement and sensory disturbances, the same direction hemianopia, both sides of the pupils are not equal to the light response, and some patients may have lethargy, polyuria and obesity and other indicators easily differentiated from lateral ventricle tumors .

(8) Midbrain tumors Mid-brain tumors, especially the midbrain capped tumors, due to their oppression of the midbrain aqueduct, the symptoms of increased intracranial pressure appear earlier, often as the first symptom, patients often merged with Occasion of the nerves of the eyes, hemiplegia, hemiplegia or axillosis, oculomotor paralysis combined with contralateral half-body ataxia, ventriculography showed lateral ventricle, third ventricle showed a significant increase in consistency, and the fourth ventricle could not be developed.

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