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Posterior transcallosal intervenous-interforniceal approach to a periaqueductal tumor

David S. Hersh, Katherine N. Sanford, and Frederick A. Boop

highlighted by the patient’s preoperative imaging. The coronal T2-weighted MRI demonstrates the separation of the forniceal crura posterior to the body of the fornix, and the lateral location of the crura relative to the internal cerebral veins. This view illustrates that a midline, posterior interhemispheric, transcallosal intervenous-interforniceal approach would provide a direct path to the underlying tumor. 3:51 Positioning and opening With this in mind, a posterior transcallosal intervenous-interforniceal approach was performed. The patient was placed in the MRI

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Endoscopic transventricular resection of a colloid cyst

Sebastian Lehmann and Henry W. S. Schroeder

placed and the navigation-guided sheath for the endoscope is carefully inserted, following the preplanned trajectory, reaching the lateral ventricle with direct view to the interventricular septum and the head of the caudate nucleus. Once the caudate nucleus head is covered by the endoscope sheath, the sheath is used as a retractor to dislocate the head of the caudate nucleus a little bit laterally to get the ideal approach to the colloid cyst’s attachment at the roof of the third ventricle. The anatomical landmarks for orientation are the fornix, the choroid plexus

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Endoscopic ultrasonic resection of calcified tumor of the third ventricle

Pietro Spennato, Nicola Onorini, Francesca Vitulli, Alessia Imperato, Lucia De Martino, Claudio Ruggiero, and Giuseppe Cinalli

only the tumor is aspirated inside the cannula, and is fragmented by the sonication inside the cannula lumen, and we don’t take any risk. 3:02 Tumor Debulking. Here we are approaching the pillar on the fornix. The bleeding starts to become a little bit more important, but the large ventricular chamber helps us to keep the vision extremely acceptable throughout the procedure. 3:19 Dissection From the Fornix. And here we are removing the adhesion of the tumor at the level of the pillar of the fornix and very close to the choroid plexus and very close to

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Interhemispheric transcallosal transchoroidal approach to a pineal teratoma in a 15-year-old boy

Giuseppe Cinalli, Maria Rosaria Scala, Alessandra Marini, Alessia Imperato, Giuseppe Mirone, and Pietro Spennato

working between the two internal cerebral veins would allow complete control of the tumor from the anterior to the posterior pole. The more posterior trajectory seems to cross the posterior column of the fornix, but dissection of the choroid fissure and the section of the anterior septal vein allows a very lateral displacement of the right internal cerebral vein, creating a very large operative corridor that allows to work always laterally to the posterior column of the fornix, minimizing the risks to injure it. 2:46 Position and Flap Position is supine, with mild

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Thalamomesencephalic cavernoma: anterior transcallosal transchoroidal approach

Francesco Certo, Giada Toccaceli, Roberto Altieri, and Giuseppe M. V. Barbagallo

useful to be guided in the surgical trajectory. 3:21 After callosotomy we could enter in the right lateral ventricle, opening a wide fissure. 3:38 The dissection of the choroidal fissure to release the choroid plexus from the fornix must be performed extremely carefully. So, having identified the choroid plexus, the thalamostriate veins, and, anteriorly, the Monro foramen, we proceeded to a careful dissection of choroidal fissure, to release the choroid plexus from the fornix, avoiding any kind of injury. 4:03 Identification of thalamostriate veins and foramen of Monro

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Feasibility of extended transforaminal approach (medial subchoroid) for resection of a benign aqueductal tumor in a patient with type 1 neurofibromatosis

Jose M. Narro-Donate, Jose J. Guil-Ibañez, Maria José Castelló-Ruiz, Fernando García-Pérez, Gaizka Urreta-Juarez, and José Masegosa-González

ventriculostomy by guiding the endoscope to the anterior part of the floor of the third ventricle. Mammillary bodies and premammillary membrane are identified. With the bipolar tool, we perforate the membrane and then use a 4-Fr Fogarty to dilate the perforation. Once completed, the endoscope is introduced to confirm the correct perforation of the Liliequist membrane. The basilar artery is identified with no significant surgical complications. 5:57 Damage Verification. When the endoscope is removed, the absence of lesions on the fornix is confirmed. 6 The medial

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Interhemispheric transcallosal intervenous approach to a pineal region tumor

Daniel A. Donoho and Guillermo Aldave

before the dissection of the velum interpositum in the midline, we expose also the right lateral ventricle as we can see. Once we have both lateral ventricles exposed, we move forward with the exposure of the tela choroidea in the roof of the third ventricle. Doing the midline dissection close to the splenium of the corpus callosum it is always safe, as the body of the fornices should have already left the midline and turned into the crus of the fornix in the anterior wall of the atrium. 6 In this dissection of the velum interpositum, we can identify all the layers

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Minimally invasive techniques: full endoscopic inferior parietal lobule approach for an endoventricular removal of a left trigone meningioma grade I

Clarissa A. E. Gelmi, Giulio Cecchini, Giovanni Vitale, and Francesco Di Biase

fornix in white, which turned around the thalamus on the anteromedial aspect. After having detached the lesion from the ependyma and rolling it on the surgical site, avoiding any retraction, we could appreciate the choroidal plexus still kept the lesion adherent to this area. This kind of surgical vision was possible only thanks to the endoscope. We continued then to debulk the tumor to better expose its base of implant, which we finally cauterized, avoiding the rupture of the small cicatricial synechiae and choroidal vessels associated; otherwise, there may be

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Occipital interhemispheric transtentorial approach to a pineoblastoma in a 4-year-old child

Alessia Imperato, Alessandra Marini, Pietro Spennato, Giuseppe Mirone, and Giuseppe Cinalli

. At the end of the procedure, only minor contusions of massa intermedia and fornix are visible without clinical consequences. This is the immediate postoperative CT scan showing clean ventriculoscopy track with safety EVD that was removed 48 hours later. MRI performed 3 months after biopsy showed on T2, DWI, and dADC sequences absence of white matter damage in the right frontal lobe following the single burr hole procedure, to prove safety and feasibility of the technique in presence of anatomical conditions and with a good preoperative planning. Histology