RESUMO
The authors present the case of a 58-year-old woman. At presentation the patient complained of vertigo and noise in the ears with six months history, and from headache, accompanied by nausea and vomiting from three months. The physical examination of the patient found no abnormalities. The neurological examination revealed discoordination syndrome and mild hemiparesis of the left limbs. Computed tomography of the brain without and with contrast medium showed oval tumor, localized in the region of trigonum collaterale and the posterior horn of the right lateral ventricle. Operative intervention was performed after a preoperative management of the patient: transcortical fenestration of the brain in the region of trigonum collaterale and the posterior horn of the right lateral ventricle. The tumor was totally removed. It is well isolated, oval in shape, with feeding blood vessel from plexus chorioideus and was attached to the wall of the ventricle with several thin bridges. Macroscopically the tumor was 3 cm in diameter, with smooth walls, well capsulated, grey-brownish in color and with firm elastic consistence. The histological findings revealed meningioma--meningotheliomatose variant.
Assuntos
Neoplasias do Ventrículo Cerebral/diagnóstico , Meningioma/diagnóstico , Neoplasias do Ventrículo Cerebral/patologia , Neoplasias do Ventrículo Cerebral/cirurgia , Feminino , Humanos , Meningioma/patologia , Meningioma/cirurgia , Pessoa de Meia-IdadeRESUMO
The authors present the case of a 34-year-old man. The patients was admitted for the second time in the clinic. A year before an epidermoid cyst of the third ventricle, obstructing the two foramen Monroe and causing acute hydrocephaly, was surgically removed. In the operative intervention a cerebral fenestration of the lateral cerebral ventricle was performed and the epidermoid cyst was totally extirpated through the right foramen Monroe under operative microscope. The patient was discharged in excellent state, without complaints and neurological symptoms. The patient received attacks of severe headaches, staggering gate and double vision two months before his second admission. The neurological examination revealed paresis of left nervus abducens, staggering gait and pronounced psychic symptoms. The computed tomography of the brain revealed cystic formation, 3.4 cm in diameter, in the front part of the third cerebral ventricle. The intervention was performed after preoperative management of the patient and a cystic tumor with the histologic characteristics of an epidermoid cyst was totally extirpated under operative microscope, using the same approach as in the first operation. The patient was discharged in good state without complaints and no abnormalities detected in the neurological status.