Fourth ventricle

Anatomy and clinical significance

1. Fourth Ventricle By : Dr Abhishek Kumar Rai DNB Third year resident Sakra World Hospital

2. The fourth ventricle is a broad tent shaped midline cavity, located between cerebellum and brainstem. Cavity of hind brain. 2 Introduction

3. T he neural tube forms around the fourth week of gestation. The center, hollow portion of the neural tube eventually develops into the ventricular system. Three dilations , called the prosencephalon , mesencephalon, and rhombencephalon , form from the neural tube . Within each of these dilations that develop from the neural tube are cavities that become the ventricles. The cavity located in the rhombencephalon becomes the fourth ventricle. 3 Embryology

4. posterior inferior cerebellar artery (PICA ) anterior inferior cerebellar artery ( AICA) superior cerebellar artery (SCA ). 4 Blood Supply and Lymphatics

5. Recess are extension of main cavity of ventricle. Lateral - 2 Medial Dorsal - 1 Lateral Dorsal - 2 5 Recess

6. Inf cerebellar peduncle (Ventral) LR Floccus (Dorsally) 6 Lateral Recess Reach up to Flocculus Foramen of luschka

7. Medial cerebellar peduncle : extension into white core of cerebellum. Lies just in front of Nodule Lateral dorsal recess : Lies above inferior medullary velum Lateral to Nodule 7 Recess

8. Superior Inferior Lateral 8 Angle

9. Lateral wall Floor Roof 9 Boundaries

10. Superolateral Superior cerebellar peduncle Inferolateral Inferior cerebellar peduncle Gracile and cuneate tubercle 10 Lateral wall

11. 11 Floor

12. 12 Roof

13. Medulloblastomas Ependymomas Astrocytomas Dandy-walker cysts Metastasis to choroid plexus or ependyma is most common in adults Epidermoid cyst Neurofibroma 13 Common lesions

14. The line of attachment of inf med velum to Tela is Telovelar junction, extend from nodule into each lateral recess. Hydrocephalus is one of the conditions that can result from: in Arnold Chiari malformation (Type II Chiari malformation) and Other masses Medulloblastom , arises in the cerebellum and can therefore impinge on the roof of the fourth ventricle. 14 Clinical

15. 15 Clinical

16. Thank You