Posterior interhemispheric approach and microsurgical resection of a pineal parenchymal neoplasm of intermediate differentiation

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Owing to a deep-seated location and intricate venous anatomy, pathologies of the posterior third ventricular region pose formidable challenges to the operating neurosurgeon. In this video, we present a case of an elderly Caucasian female with a rare histological variant of a pineal parenchymal mass who presented with gait disturbances and worsening retro-orbital headache. Radiological and clinco-histopathological correlates of this rare tumor pathology having intermediate differentiation are highlighted. Briefly outlined are surgical pearls and strategies to minimize complications, as the tumor is approached through the posterior interhemispheric corridor, to achieve a gross-total decompression.

The video can be found here: https://youtu.be/KXwclZ7Ei84.

Owing to a deep-seated location and intricate venous anatomy, pathologies of the posterior third ventricular region pose formidable challenges to the operating neurosurgeon. In this video, we present a case of an elderly Caucasian female with a rare histological variant of a pineal parenchymal mass who presented with gait disturbances and worsening retro-orbital headache. Radiological and clinco-histopathological correlates of this rare tumor pathology having intermediate differentiation are highlighted. Briefly outlined are surgical pearls and strategies to minimize complications, as the tumor is approached through the posterior interhemispheric corridor, to achieve a gross-total decompression.

The video can be found here: https://youtu.be/KXwclZ7Ei84.

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Article Information

INCLUDE WHEN CITING Published online January 1, 2016; DOI: http://thejns.org/doi/abs/10.3171/2016.1.FocusVid.15439.

CORRESPONDENCE Anil Nanda MD, MPH, FACS, Department of Neurosurgery, Louisiana State Health Sciences Center – Shreveport, PO Box 33932, 1501 Kings Highway, Shreveport, LA 71130-3932. email: ananda@lsuhsc.edu.

© AANS, except where prohibited by US copyright law.

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