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Cavernous malformations of the third ventricle

G Sinson¹, E L Zager, R I Grossman

¹Division of Neurosurgery, Hospital of University of Pennsylvania, Philadelphia, USA.

|July 1, 1995

Summary

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Cavernous malformations in the third ventricle are rare brain lesions. Surgical excision is a viable treatment, though risks like hypothalamic venous infarction exist, impacting patient outcomes.

Area of Science:

Neurology
Neurosurgery
Radiology

Background:

Cavernous malformations (CMs) are uncommon vascular brain lesions.
Typically found in cerebral hemispheres, they can occur in the brainstem, basal ganglia, or paraventricular regions.

Observation:

This study reports four cases of cavernous malformations specifically located in the third ventricle.
Patients presented with hydrocephalus, memory loss, and hypothalamic dysfunction.
Preoperative diagnosis was confirmed using magnetic resonance imaging (MRI) and computed tomography (CT).

Findings:

Surgical excision was performed using various approaches: transcallosal transventricular, transcortical transventricular, and infratentorial supracerebellar.
Two patients achieved a return to their baseline neurological function post-surgery.

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One patient with hypothalamic dysfunction did not improve and required shunting, while another experienced a fatal hypothalamic venous infarction postoperatively.

Implications:

Direct surgical excision is a treatment option for third ventricle cavernous malformations.
The location of these lesions poses significant surgical challenges and risks, including potential vascular complications.
Careful preoperative assessment and surgical planning are crucial for optimizing outcomes in these rare cases.