S ymptoms of hydrocephalus in adults are generally related to intracranial hypertension, mental deterioration, and gait and sphincter disorders. The intriguing case presented here involved massive sialorrhea due to hypertensive hydrocephalus, with prominentfourthventricleenlargement. The condition resolved after cerebrospinal fluid (CSF) diversion. Case Report This 50-year-old man had been suffering from sialorrhea for 1 year, and gait instability and sporadic vomiting had occurred during the month before presentation. No head trauma, meningitis

W e recently operated on a patient with a calcified tumor of thefourthventriclewhich proved to be a myxochondrosarcoma, a tumor rarely encountered in neurosurgical practice. Case Report This 39-year-old man was admitted to the New England Medical Center Hospital on May 5, 1974, complaining of severe occipital headaches, nausea, and vomiting. History . Eight months previously he had been hospitalized on the Neurology Service because of diplopia of one month's duration. Neurological examination at that time revealed lateral and vertical nystagmus

I ntracranial teratomas are particularly rare in the posterior fossa. In the large Harvard series 4 of intracranial tumors of infancy and childhood, only 11 such lesions were documented. While the midline is an acknowledged favorite site for these tumors, only 10 have been reported in the posterior fossa. 6 This is the second case recorded in which a teratoma occupied thefourthventricle. Case Report A 2½-year-old girl was seen 2 weeks after the onset of projectile vomiting and ataxia following an upper respiratory tract infection. The child was known

devoted to speculation as to the cell of origin 2, 3, 5, 9 until a series of 21 symptomatic subependymomas was published by Scheithauer 11 in 1978. This established the clinical relevance of the tumor and documented the high operative mortality rate associated with its excision. In Scheithauer's series, 11 thefourthventricleharbored the majority of incidental lesions, but this site was associated with a worse prognosis if the tumor became symptomatic. We have reviewed our experience with subependymomas of thefourthventricle, analyzing the cases with regard to

who, after initial debridement of a right parietal gunshot wound, developed rapidly increasing intracranial pressure over the next 12 hours. Ventriculography revealed that the missile had become lodged in the rostral end of the aqueduct. During the attempted removal of the bullet, the patient died. We have been unable to find any cases reported of missiles within thefourthventricleand we are describing one such case. Case Report A 29-year-old woman was shot at close range with a small caliber pistol. The missile entered the skull high in the left parietal

N euroendoscopic anatomy of thefourthventriclehas been reported infrequently in the literature, mainly based on laboratory experiences or, more rarely, in accounts of caudocranial suboccipital surgical approaches. 3 , 4 , 6 , 12 , 16 , 19 Even neurosurgeons familiar with flexible endoscopes have scarcely taken advantage of the extraordinary versatility of their instruments to achieve complete visual control of all the ventricular cavities. 7 Nonetheless, the transaqueductal approach to thefourthventricleperformed with flexible scopes has been

I ntraventricular epithelial-lined cysts of thefourthventricleare extremely rare, and the few reports found in the literature have suggested that they may be related by origin to the colloid or neuroepithelial cysts of the thirdventricle. The present report describes a patient with afourthventricular cyst in which the histology of the cyst wall resembles that of an embryonic enterogenous cyst of the spinal cord. To our knowledge this characteristic has not been described before. Case Report This 48-year-old woman presented in July, 1979, with a 9

T he recognition of new types of LGGs containing distinct neurocytic components has broadened the spectrum of glioneuronal tumors. 1–5 Some features indicate that these tumors may arise from neural stem cells capable of glial and neurocytic differentiation. Rosette-forming glioneuronal tumors of thefourthventriclerepresent a recently described variant that must be differentiated from several LGGs and glioneuronal tumors. In the present report we illustrate a case and review diagnostic considerations. Case Report History. This 29-year

N euroepithelial cysts rarely occur beyond the thirdventricle. They are found along the spinal canal, 13 above the tentorium, 10, 14 and at extraventricular sites in the posterior fossa. 1, 6, 12 In 1952, Parkinson and Childe 15 described a surgical specimen of such a lesion from thefourthventricle. We are reporting the pathological study of a neuroepithelial cyst within thefourthventricle. Case Report This 15-year-old girl consulted an ophthalmologist in 1974 for progressive impairment of vision for 6 weeks and pounding headaches for 3 months

S ubependymoma was first recognized as a pathological entity by Scheinker in 1945. 18 The great majority of subependymomas are found incidentally at autopsy in thefourthventricleof elderly men. 15 Symptom-producing tumors, however, are recorded in the literature, their location varying from the region of thefourthventricleto the walls of the lateralventricles, the septum pellucidum, spinal cord, foramen of Monro, and aqueduct of Sylvius. 1, 2, 4, 5, 7, 8, 10, 11, 13, 16, 18 We are reporting a case of symptomatic subependymoma of thefourthventricle