脑室四肿瘤占颅内肿瘤的1%-5%，呈现不同构型和解剖挑战。显微外科手术是大多数脑室四肿瘤的主要治疗策略，充分的解剖理解和可视化对手术规划和成功至关重要。作者介绍了一例年轻患者的复杂脑室四肿瘤病例，手术计划成功地使用了一种新颖的混合现实（MxR）系统。本文介绍了一位31岁女性患者的病例，病变从脑室四延伸到桥脑板，导致阻塞性脑积水症状。通过常规2D影像和交互式3D解剖模型的结合使用，采用了两半球经张帐压迫韧带途径并成功切除了98%的病变，具有良好的功能结果。将先进的3D可视化技术与新颖的MxR系统应用于复杂脑室四病变的手术规划，可为设计最佳手术途径和轨迹，更好地识别潜在的术中挑战和预演病人特异性解剖提供参考。本病例报告支持将先进的3D可视化技术应用于常规围手术期实践。 © 2023 Colombo, Bektas, Regli and van Doormaal.

Tumors of the fourth ventricle account for 1%-5% of all intracranial neoplastic lesions and present with different configurations and anatomical challenges. Microsurgery represents the primary therapeutic strategy for the majority of fourth ventricular tumors, and adequate anatomical understanding and visualization are paramount to surgical planning and success. The authors present the case of a young patient with a complex fourth ventricular tumor, whose surgery was successfully planned using a novel mixed reality (MxR) system.We present a case of a 31-year-old woman with a lesion extending from the fourth ventricle to the lamina quadrigemina and causing symptomatic hydrocephalus occlusus. Through the combined use of routine 2D images and an interactive 3D anatomical model, an interhemispheric transtentorial approach was used to remove 98% of the lesion with successful functional outcomes.The application of advanced 3D visualization with a novel MxR system to the surgical planning of a complex fourth ventricular lesion proved relevant in designing the best surgical approach and trajectory to better identify potential intraoperative challenges and rehearse the patient-specific anatomy. The present case report endorses the implementation of advanced 3D visualization in routine perioperative practice.© 2023 Colombo, Bektas, Regli and van Doormaal.