BRAIN - Ependymoma, fourth ventricle

The fourth ventricle is enlarged by a tumour some 4 x 3 cm. The cerebellum and brain stem are distorted and there is extensive haemorrhage posteriorly and in the subarachnoid space at the base. The third ventricle is grossly dilated and there is a moderate degree of dilatation of the lateral ventricles. The convolutions of the cerebellum are flattened.
This 2-year-old child had become listless and stopped talking except in monosyllables over the previous three months. Her muscles were hypotonic and floppy. She became more and more drowsy and developed an intermittent sixth nerve palsy with progressively more feeble respiration. Examination and subsequent surgery determined the presence of an ependymoma in the fourth ventricle. The child died postoperatively.