UNASSIGNED: The triangular recess (TR), also called triangular fossa or vulva cerebri, represents the anterior extension of the diencephalic ventricle, located between the anterior columns of the fornix and the anterior white commissure. Over time, this structure of the third cerebral ventricle generated many disputes. While some anatomists support its presence, others have opposite opinions, considering that it only becomes visible under certain conditions. The aim of the study is to demonstrate the tangible structure of the triangular recess. Secondly, the quantitative analysis allowed us to establish an anatomical morphometric standard, as well as the deviations from the standard.
UNASSIGNED: Our study is both a quantitative and a qualitative evaluation of the triangular fossa. We dissected 100 non-neurological adult brains, which were fixed in 10% formaldehyde solution for 10 weeks. The samples are part of the collection of the Institute of Anatomy, \"Grigore T. Popa\" University of Medicine and Pharmacy, Iasi. We highlighted the triangular fossa by performing dissections in two stages at the level of the roof of the III ventricle.
UNASSIGNED: The qualitative analysis is a re-evaluation of the classical data concerning the anatomy of the fossa triangularis. We proposed an original 3D model of the triangular recess in which we described a superficial part called vestibule and a deep part called pars profunda. We measured the sides of the communication between the two proposed segments, as well as the communication with the III ventricle. By applying the Heron\'s formula, we calculated the area of the two communications. Statistical evaluations have shown that these communications are higher than they are wide. In addition, there is a statistical difference between the surfaces of the two communications: 34.07 mm2 ± 7.01 vs. 271.43 mm2 ± 46.36 (p = 0.001).
UNASSIGNED: The outcome of our study is both qualitative and quantitative. Firstly, we demonstrated the existence of the triangular fossa and we conceived a spatial division of this structure. Secondly, the measurements carried out establish an anatomo-morphometric norm of the triangular recess, which is useful in assessing the degree of hydrocephalus during the third endoscopic ventriculoscopy.

UNASSIGNED: Colloid cysts are rare brain tumors that can cause headaches, memory problems, and vision issues. Early diagnosis and treatment are crucial to prevent complications.
UNASSIGNED: The authors report a case of a patient in their 20s with a 2-year history of headaches and blurry vision. A computed tomography (CT) scan revealed a colloid cyst in the third ventricle. The patient was diagnosed with astigmatism and managed with corrective lenses and regular CT scans.
UNASSIGNED: The patient\'s astigmatism may be linked to the colloid cyst, potentially due to migraines triggered by the cyst\'s location. Further research is needed to understand this relationship.
UNASSIGNED: This case highlights the potential for colloid cysts to contribute to vision problems. Careful evaluation and individualized management are essential for patients with colloid cysts and vision disturbances.

Colloid cysts of the third ventricle are rare, benign intracranial tumors that can cause significant neurological symptoms and complications, particularly when they lead to obstructive hydrocephalus. The aim of this study is to present a case of a large third ventricle colloid cyst causing acute hydrocephalus and fainting attacks, necessitating emergency surgery. This is a case of a 46-year-old female presenting with headaches and recurrent fainting attacks. Cardiac evaluations were normal. Brain MRI revealed a 3x3 cm cystic lesion in the anterior superior portion of the third ventricle, causing moderate hydrocephalus with a transependymal edema. Due to acute hydrocephalus and fainting attacks attributed to arrhythmias from hypothalamic compression, emergency surgical resection was performed. A contralateral interhemispheric transcallosal approach with a right frontal craniotomy was used to achieve gross total resection. Postoperative recovery was uneventful, and a follow-up MRI showed an empty tumor bed and resolved hydrocephalus. In conclusion, prompt diagnosis and emergency surgical intervention are crucial in cases of acute hydrocephalus caused by third ventricle colloid cysts. The successful outcome of this emergency resection demonstrates the effectiveness of timely surgical management in preventing severe complications.

The ependyma lining the third ventricle (3V) in the mediobasal hypothalamus plays a crucial role in energy balance and glucose homeostasis. It is characterized by a high functional heterogeneity and plasticity, but the underlying molecular mechanisms governing its features are not fully understood. Here, 5481 hypothalamic ependymocytes were cataloged using FACS-assisted scRNAseq from fed, 12h-fasted, and 24h-fasted adult male mice. With standard clustering analysis, typical ependymal cells and β2-tanycytes appear sharply defined, but other subpopulations, β1- and α-tanycytes, display fuzzy boundaries with few or no specific markers. Pseudospatial approaches, based on the 3V neuroanatomical distribution, enable the identification of specific versus shared tanycyte markers and subgroup-specific versus general tanycyte functions. We show that fasting dynamically shifts gene expression patterns along the 3V, leading to a spatial redistribution of cell type-specific responses. Altogether, we show that changes in energy status induce metabolic and functional switches in tanycyte subpopulations, providing insights into molecular and functional diversity and plasticity within the tanycyte population.

UNASSIGNED: Ventriculoperitoneal shunt insertion (VPSI) and endoscopic third ventriculostomy (ETV) are the major procedures for treating pediatric hydrocephalus. However, studies comparing motor development following the two treatments are limited.
UNASSIGNED: We aimed to determine motor development outcomes in children with hydrocephalus up to 2 years of age after undergoing VPSI or ETV, to identify which surgical approach yields better motor outcomes and may be more effective for Malawian children.
UNASSIGNED: This was a cross-sectional study where we recruited two groups of participants: one group consisted of children with hydrocephalus treated with VP shunt whilst the other group were treated with ETV, at least 6 months prior to this study. Participants were identified from the hospital records and were called to come for neurodevelopmental assessment using the Malawi Development Assessment Tool (MDAT).
UNASSIGNED: A total 152 children treated for hydrocephalus within an 18-month period met the inclusion criteria. Upon follow up and tracing, we recruited 25 children who had been treated: 12 had VPSI and 13 had ETV. MDAT revealed delays in both assessed motor domains: 19 out of the 25 children had delayed gross motor whilst 16 of 25 had delayed fine motor development. There was no significant difference between the shunted and the ETV groups.
UNASSIGNED: Children with hydrocephalus demonstrate delays in motor development six to 18 months after treatment with either VPSI or ETV. This may necessitate early and prolonged intensive rehabilitation to restore motor function after surgery. Long-term follow-up studies with bigger sample sizes are required to detect the effect of the two treatment approaches.

OBJECTIVE: Transcranial sonography (TCS) is a noninvasive neuroimaging technique, visualizing deep brain structures and the ventricular system. Although widely employed in diagnosing various movement disorders, such as Parkinson\'s disease and dystonia, by detecting disease-specific abnormalities, the specific characteristics of the TCS in cerebellar ataxia remain inconclusive. We aimed to assess the potential value of TCS in patients with cerebellar ataxias for disease diagnosis and severity assessment.
METHODS: TCS on patients with genetic and acquired cerebellar ataxia, including 94 with spinocerebellar ataxias (SCAs) containing 10 asymptomatic carriers, 95 with cerebellar subtype of multiple system atrophy (MSA-C), and 100 healthy controls (HC), was conducted. Assessments included third ventricle width, substantia nigra (SN) and lentiform nucleus (LN) echogenicity, along with comprehensive clinical evaluations and genetic testing.
RESULTS: The study revealed significant TCS abnormalities in patients with cerebellar ataxia, such as enlarged third ventricle widths and elevated rates of hyperechogenic SN and LN. TCS showed high accuracy in distinguishing patients with SCA or MSA-C from HC, with an AUC of 0.870 and 0.931, respectively. TCS abnormalities aided in identifying asymptomatic SCA carriers, effectively differentiating them from HC, with an AUC of 0.725. Furthermore, third ventricle width was significantly correlated with SARA and ICARS scores in patients with SCA3 and SCOPA-AUT scores in patients with MSA-C. The SN area and SARA or ICARS scores in patients with SCA3 were also positively correlated.
CONCLUSIONS: Our findings illustrate remarkable TCS abnormalities in patients with cerebellar ataxia, serving as potential biomarkers for clinical diagnosis and progression assessment.

Choroid plexus papillomas are rare brain neoplasms, primarily observed in children, and typically manifest with symptoms indicative of heightened intracranial pressure and cerebral irritation. In addition, the tumor\'s localization varies with the patient\'s age, and diagnostic and therapeutic approaches predominantly rely on imaging findings and surgical interventions, with histopathological examination being essential for confirmation. This study outlines a unique instance of choroid plexus papilloma in a 30-year-old female, who presented with severe headache and vomiting, subsequently revealing hydrocephalus on Brain CT. Remarkably, the tumor was identified in the Foramen of Monro, an exceedingly rare and unreported location in adults. Notably, the patient underwent successful endoscopic resection without complications, a technique sparsely documented in similar cases. Choroid plexus papilloma, predominantly afflicting children, displays varied tumor locations depending on the patient\'s age. Our report highlights an exceptional case with an atypical tumor location that was not reported before to our knowledge, and addressed through an innovative endoscopic resection method that was recently used in the management of such cases. This underscores the importance of considering diverse tumor presentations, as it has a favorable prognosis achievable through management, especially with the increasing number of reported cases. Moreover, it advocates for the adoption of emerging endoscopic approaches, which exhibit promising outcomes.

Neuroendoscopy procedures in pediatrics have expanded beyond the endoscopic third ventriculostomy. As such, a direct and angled endoscope allows further visualization around the corner, capturing the surrounding anatomy. Intraoperative live images look different than radiological images. Hence, in this single institutional experience, we correlate neuroradiology images with intraoperative intraventricular endoscopic views of the third-fourth ventricle, pituitary, pineal gland, cerebral aqueduct, and foramen magendie and luschka. Our collective case series reveals a few interesting case scenarios of normal and abnormal findings during the procedure. Careful navigation of the neuroendoscope is crucial to prevent injury to the neurovascular bundle. A close relationship with normal anatomy from radiological imaging is necessary to prevent it from getting lost once inside the ventricular cavity.

Endoscopic third ventriculostomy (ETV) is a well-established surgical technique for treating hydrocephalus. Many providers have transitioned to utilizing the specialized Neuroballoon for the stoma dilation in ETV; however, these devices are intermittently unavailable during supply chain shortages. We present the experience of employing cardiac angioplasty and neurovascular balloons as substitutes for the Neuroballoon in 3 patients. The scepter balloon (Microvention), priced at $1800 compared to the standard $300 Neuroballoon (Integra), proved effective, but its pliability presented technical challenges. The substantial cost differential compared to a Neuroballoon ($300) raises economic considerations. The Cardiac TREK balloon (Abbott) was similarly effective, while also being easier to manage endoscopically and cheaper at $158. These experiences support the viability of non-neuroendoscopic specialized balloons as alternatives for ETV dilation of the floor of tuber cinereum.

We report a case of a mid-20s primigravida at 37 weeks\' gestation who presented with severe headache and acute neurological deterioration. The CT brain scan showed hydrocephalus caused by a colloid cyst in the third ventricle. The patient underwent emergency placement of an external ventricular drain for decompression of acute hydrocephalus. Four hours later, labour commenced spontaneously, and in view of her neurological status, a decision was taken to perform a caesarean section under general anaesthetics. Four days postpartum, the patient underwent an endoscopic removal of the cyst. Intracranial emergencies during pregnancy are rare and challenging to manage. The mortality rate can be significant. Diagnostic and surgical intervention should not be delayed because of pregnancy. An individualised treatment approach is required with multidisciplinary input. The collaborative efforts of our multidisciplinary team resulted in prompt diagnosis and surgical treatment in this case that resulted in both a healthy mother and child.