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Short case publication... Version 3.19 | Edited by professor Yasser Metwally | April 2010




                                                                                                          Short case

                                                                                                         Edited by
                                                                                                 Professor Yasser Metwally
                                                                                                   Professor of neurology
                                                                                               Ain Shams university school of medicine
                                                                                                          Cairo, Egypt

                                                                                                    Visit my web site at:
                                                                                                 http://yassermetwally.com




A 26 years old male patient presented with manifestations of increased intracranial pressue.




DIAGNOSIS: INTRAVENTRICULAR SUPRATENTORIAL EPENDYMOMA
Figure 1. Precontrast CT scan: Intraventricular ependymoma
                                              filling the lateral and third ventricle, the lesion shows extensive
                                              perivascular calcification. The tumor is a huge one, involving both
                                              lateral ventricles and causing extensivehydrocephalus.




Figure 2. Postcontrast CT scan: Intraventricular ependymoma filling the lateral and third ventricle, the lesion
shows extensive perivascular calcification (Actually perivenous) and is drained by the deep venous system
through the vein of galen. Notice the dense homogeneous enhancement. Hydrocephalic changes are seen with
possible transependymal edema (A). (C is a bone window of B)
Figure 3. Angiography shows the extensive tumour hypervascularity that is mainly drained by the deep
venous system through the vein of galen.




Figure 4. The tumor has extended to the third ventricle, ? the interhemispheric fissure, and Probably the
suprasellar and the quadrigeminal cistern. CSF seedling is probably the cause of dissemination through the basal
cisterns and the bihemispheric fissures.
Figure 5. Histopathological picture of ependymomas with the
                                                             characteristic rosettes (The patient's histopathology)




The patient's tumor was debulked surgically and histopathological examination revealed an ependymoma of the
cellular type with Perivascular pseudorosettes. The patient was given a course of postoperative radiotherapy (Fig.
5). The patient died 7 month following the operation.




References

1. Metwally, MYM: Textbook of neurimaging, A CD-ROM publication, (Metwally, MYM editor) WEB-CD agency for
electronic publishing, version 11.2a April 2010

Addendum

  A new version of short case is uploaded in my web site every week (every Saturday and remains available till Friday.)
  To download the current version follow the link "http://pdf.yassermetwally.com/short.pdf".
  You can download the long case version of this short case during the same week from: http://pdf.yassermetwally.com/case.pdf or visit web
  site: http://pdf.yassermetwally.com
  To download the software version of the publication (crow.exe) follow the link: http://neurology.yassermetwally.com/crow.zip
  At the end of each year, all the publications are compiled on a single CD-ROM, please contact the author to know more
  details.
  Also to view a list of the previously published case records follow the following link:
   (http://wordpress.com/tag/case-record/) or click on it if it appears as a link in your PDF reader
  To inspect the patient's full radiological study, click on the attachment icon (the paper clip icon in the left pane) of the acrobat
  reader then double click on the attached file
  Click here to download the long case version of this short case in PDF format

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Short case...Intraventricular ependymoma

  • 1. Short case publication... Version 3.19 | Edited by professor Yasser Metwally | April 2010 Short case Edited by Professor Yasser Metwally Professor of neurology Ain Shams university school of medicine Cairo, Egypt Visit my web site at: http://yassermetwally.com A 26 years old male patient presented with manifestations of increased intracranial pressue. DIAGNOSIS: INTRAVENTRICULAR SUPRATENTORIAL EPENDYMOMA
  • 2. Figure 1. Precontrast CT scan: Intraventricular ependymoma filling the lateral and third ventricle, the lesion shows extensive perivascular calcification. The tumor is a huge one, involving both lateral ventricles and causing extensivehydrocephalus. Figure 2. Postcontrast CT scan: Intraventricular ependymoma filling the lateral and third ventricle, the lesion shows extensive perivascular calcification (Actually perivenous) and is drained by the deep venous system through the vein of galen. Notice the dense homogeneous enhancement. Hydrocephalic changes are seen with possible transependymal edema (A). (C is a bone window of B)
  • 3. Figure 3. Angiography shows the extensive tumour hypervascularity that is mainly drained by the deep venous system through the vein of galen. Figure 4. The tumor has extended to the third ventricle, ? the interhemispheric fissure, and Probably the suprasellar and the quadrigeminal cistern. CSF seedling is probably the cause of dissemination through the basal cisterns and the bihemispheric fissures.
  • 4. Figure 5. Histopathological picture of ependymomas with the characteristic rosettes (The patient's histopathology) The patient's tumor was debulked surgically and histopathological examination revealed an ependymoma of the cellular type with Perivascular pseudorosettes. The patient was given a course of postoperative radiotherapy (Fig. 5). The patient died 7 month following the operation. References 1. Metwally, MYM: Textbook of neurimaging, A CD-ROM publication, (Metwally, MYM editor) WEB-CD agency for electronic publishing, version 11.2a April 2010 Addendum A new version of short case is uploaded in my web site every week (every Saturday and remains available till Friday.) To download the current version follow the link "http://pdf.yassermetwally.com/short.pdf". You can download the long case version of this short case during the same week from: http://pdf.yassermetwally.com/case.pdf or visit web site: http://pdf.yassermetwally.com To download the software version of the publication (crow.exe) follow the link: http://neurology.yassermetwally.com/crow.zip At the end of each year, all the publications are compiled on a single CD-ROM, please contact the author to know more details. Also to view a list of the previously published case records follow the following link: (http://wordpress.com/tag/case-record/) or click on it if it appears as a link in your PDF reader To inspect the patient's full radiological study, click on the attachment icon (the paper clip icon in the left pane) of the acrobat reader then double click on the attached file Click here to download the long case version of this short case in PDF format