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Fourth Ventricular Tumors

Last Updated: September 29, 2018

Resection of a Fourth Ventricular Ependymoma Adherent to the Floor of the Ventricle

Fourth ventricular tumors pose a surgical challenge, albeit less than their third ventricular counterparts, because of their relation to the brainstem; this relation can vary from simply displacement to invasion.

This technical challenge is further complicated because the tumor is often concealed by key cerebellar structures, including the cerebellar tonsils and hemispheres or the vermis. Tumors may involve adjacent structures through extension via the foramen of Luschka and by reaching the premedullary, cerebellomedullary, prepontine, and anterior spinal cisterns.

The major structures that compose the borders of the fourth ventricle along the craniocaudal extent are:

  • Anteriorly (floor): midbrain, p...