Background and Aims We investigate the clinical characteristics and the microsurgery for tumors in the fourth ventricle tumors in children.
Methods The clinical data of 18 cases of pediatric fourth ventricular tumor were prospectively analyzed. The main clinical manifestations were headache (16 cases), vomiting (6 cases), visual impairment and positive Romberg sign. The imagination examination showed the tumor was in fourth ventricle, diametered from 2.5cm to 7cm. On CT or MRI, all the patients manifested with hydrocephalus.
Results Operation was carried out under microsurgical conditions. According to the size and the position the tumor, different operation approach was performed. Median suboccipital approach was adopted for 6 cases, and cerebellomedullary fissure approach for 12 cases. The bone window was 4cm×3cm. Total removal of the tumor was made for 16 cases, subtotal removal for 2 cases. Eight patients had external ventricular drainage during operations. The postoperative pathology finding were as follows. There were 13 cases of medulloblastoma, 2 cases of hemangioblastomas, 2 cases of ependymomas, and I case of pilocytic astrocytoma. Postoperative radiotherapy was achieved for 11 patients. The main symptoms were all improved for all patients. There were no complications and recurrence of tumors after follow-up of 2 years.
Conclusions According the size, the position and the pathological findings, the combined therapy is essential, and microsurgery is effective for tumors in the fourth ventricle tumors in children.