Clinical Review Of Microsurgery Treatment Of The Fourth Ventricular Tumors: Report Of 44 Cases

ObjectiveThe fourth ventricular tumors are a kind of common intracranial tumors that originate from the fourth ventricle or the cerebellar vermis. The tumors often compress the brain stem and are difficult to be resected totally. Here we reviewed the microsurgical treatment of 44 cases of the fourth ventricular tumors and summaried the principles and advantages of microsurgery to improve the effects of the treatment of the fourth ventricular tumors.Methods44 cases received microsurgical treatment with diagnosis of the fourth ventricular tumors were analyzed retrospectively, including the clinical manifestations, the imaging characteristics, excision extension of the tumors and postoperative complications.ResultsIn 44 cases, total resection was achieved in 36, subtotal resection in 8 case. The pathological results of 44 patients are 25 ependymomas,9 medulloblastomas,3 hemangioblastomas,2 astrocytomas,2 papilloma choroideum,1 cholesteatoma,1 metastatic tumor, and 1 meningioma. The complications of 44 patients included: hydrocephalus in 9 cases, limb weakness in 4, lung infection in 4, intracranial infection in 2, dysphagia and hydroposia bucking in 3, diplopia in 2, stress ulcer in 2, subscalp effusion in 2, cerebellar mutism in 1, epidural hematoma in 1, and death in 2.The patients were followed up for 1 month to 5 years,3 patients died and 4 patients were lost of follow-up in 44 case.ConclusionMicrosurgery can improve the total resection rate of fourth ventricular tumors, reduce the incidences of brain stem injury and postoperative complications and improve the patients' prognosis. The important factor that influenced the total resection is the relationship between the location of tumor and the bottom of fourth ventricle.