title: Choroid plexus of the fourth ventricle: Review and anatomic study highlighting anatomical variations.
abstract: Relatively few studies have been performed that analyze the morphology of the choroid plexus of the fourth ventricle. Due to the importance of this tissue as a landmark on imaging and during surgical intervention of the fourth ventricle, the authors performed a cadaveric study to better characterize this important structure. The choroid plexus of the fourth ventricle of 60 formalin fixed adult human brains was examined and measured. The horizontal distance from the midline to the lateral most point of the protruding tip of the horizontal limbs was measured. In the majority of the 60 brain specimens, right and left horizontal limbs of the choroid plexus were seen extending from the midline and protruding out of their respective lateral apertures of the fourth ventricle and into the subarachnoid space. However, on 3.3% of sides, there was absence of an extension into the foramen of Luschka and in one specimen, this lack of extension into the foramen of Luschka was bilateral. On two sides, there was discontinuity between the midline choroid plexus and the tuft of choroid just outside the foramen of Luschka. For specimens in which the choroid plexus did protrude through the foramen of Luschka (96.7%), these tufts were located anterior to the flocculus and inferolateral to the facial/vestibulocochlear nerve complex and posterosuperior to the glossopharyngeal/vagal/accessory complex. A thorough understanding of the normal and variant anatomy of the fourth ventricular choroid plexus is necessary for those who operate in, or interpret imaging of, this region.
authors.affiliation: Seattle Science Foundation, Seattle, WA, USA.
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.affiliation: Pediatric Neurosurgery, Children's of Alabama, Birmingham, AL, USA.
authors.forename: Mohammadali M
authors.initials: MM
authors.lastname: Shoja
authors.affiliation: Department of Anatomy, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Anjali
authors.initials: A
authors.lastname: Aggarwal
authors.affiliation: Department of Anatomy, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Tulika
authors.initials: T
authors.lastname: Gupta
authors.affiliation: Department of Anatomical Sciences, St. George's University, Grenada.
authors.forename: Marios
authors.initials: M
authors.lastname: Loukas
authors.affiliation: Department of Anatomy, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Daisy
authors.initials: D
authors.lastname: Sahni
authors.affiliation: Goodman Campbell Brain and Spine, Indiana University Department of Neurological Surgery, 355 W 16th Street, Suite 5100, Indianapolis, IN 46202, USA.
authors.forename: Shaheryar F
authors.initials: SF
authors.lastname: Ansari
authors.affiliation: Goodman Campbell Brain and Spine, Indiana University Department of Neurological Surgery, 355 W 16th Street, Suite 5100, Indianapolis, IN 46202, USA. Electronic address: acohenmd@gmail.com.
authors.forename: Aaron A
authors.initials: AA
authors.lastname: Cohen-Gadol
mesh_terms: D002831:Choroid Plexus / Q000033:anatomy & histology*; D020546:Fourth Ventricle / Q000033:anatomy & histology*; D006801:Humans; D013346:Subarachnoid Space / Q000033:anatomy & histology
keywords: Anatomy; Cerebrospinal fluid; Neuroimaging; Neurosurgery; Posterior cranial fossa