The fourth ventricle is a tent-shaped cavity between the brainstem in front and the cerebellum behind. Its diamond-shaped floor, the rhomboid fossa, overlies many cranial nerve nuclei. Cerebrospinal fluid leaves the ventricular system here, through the median and lateral apertures, to reach the subarachnoid space.
| Location | Posterior cranial fossa, behind the pons and upper medulla and in front of the cerebellum, between the cerebral aqueduct above and the central canal below |
|---|---|
| Parts |
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| Connections |
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| Blood Supply | Posterior inferior cerebellar artery (choroid plexus); Anterior inferior cerebellar artery (lateral recess choroid plexus) |
Receives cerebrospinal fluid from the aqueduct, adds more from its choroid plexus and passes it out into the subarachnoid space around the brain and spinal cord.
Posterior fossa tumours in children (medulloblastoma, ependymoma, pilocytic astrocytoma) frequently grow into or compress the fourth ventricle, causing hydrocephalus and vomiting. Dandy-Walker malformation produces a cystic, enlarged fourth ventricle. Lesions of the fourth ventricle floor damage the cranial nerve nuclei beneath it.
A tumour of the ependymal lining, common in children, that fills the fourth ventricle and may extend out through its apertures.
Isolation of the fourth ventricle when both its inflow and outflow are blocked, causing it to balloon and compress the brainstem.
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