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Anterior endoscopic transcortical approach to a pineal region cavernous hemangioma

Jiuhong Li, Jiaojiang He, Lunxin Liu, and Liangxue Zhou

, tonsillouveal transaqueductal approach may be used; however, it may lead to postoperative obstructive hydrocephalus. 2 So, we decided to use anterior endoscopic transcortical approach to achieve endoscopic third ventriculostomy (ETV) and resection of the aqueduct lesion. 1:42 Position and Incision With a supine position, we use a left frontal linear incision, and the center of the burr hole is 2 cm ahead of Kocher’s point, which is 3 cm anterior to the coronal suture and 2 cm away from the midline. This approach enables us to achieve an ETV and also access the posterior

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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

of MRI at presentation showing the midline pineal mass inducing obstructive triventricular hydrocephalus. It was decided to treat the hydrocephalus by endoscopic third ventriculostomy and biopsy the tumor with the single burr hole technique, allowing both procedures through the same approach. 1:06 Endoscopic Biopsy After identification of the ideal trajectory for ETV joining the tuber cinereum and the center of Monro foramen, and identification of the ideal trajectory for tumor biopsy joining the tumor surface and the center of Monro foramen, we identify an

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Combined microsurgical-endoscopic paramedian supracerebellar-infratentorial approach for resection of a pineal low-grade glioma

Juan M. Revuelta Barbero, Roberto M. Soriano, Rima S. Rindler, David P. Bray, Oswaldo Henriquez, C. Arturo Solares, and Gustavo Pradilla

hydrocephalus. His MR venography showed a dominant right transverse and sigmoid sinus with an absent or hypoplastic left transverse sinus. 1:10 Initial Management Due to the acute severity of his hydrocephalus, the patient was admitted for an endoscopic third ventriculostomy as well as endoscopic biopsy of the most anterior aspect of the tumor. The patient tolerated well that procedure, and pathology was consistent with a low-grade neuroepithelial tumor. 1:31 Description of the Surgical Setup An infratentorial-supracerebellar paramedian approach was selected as

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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

In this video, the authors present an interhemispheric transcallosal transchoroidal approach to a pineal mass in a 15-year-old boy. He received emergency endoscopic third ventriculostomy (ETV), then an endoscopic biopsy that revealed an immature teratoma. Surgical removal was selected. The mass was located very high in the posterior third ventricle, hidden behind the splenium of the corpus callosum and the vein of Galen, so an interhemispheric transcallosal approach followed by a complete dissection of the whole choroidal fissure was chosen and allowed complete removal of the tumor. Microsurgical dissection is presented, showing clearly in detail all the neurovascular structures encountered.

The video can be found here:

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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

presenting with hydrocephalus . Acta Neurochir (Wien) . 2019 ; 161 ( 5 ): 975 – 983 . 30953154 2 Zhu XL , Gao R , Wong GK , Single burr hole rigid endoscopic third ventriculostomy and endoscopic tumor biopsy: what is the safe displacement range for the foramen of Monro? . Asian J Surg . 2013 ; 36 ( 2 ): 74 – 82 . 23522759 3 O’Brien DF , Hayhurst C , Pizer B , Mallucci CL . Outcomes in patients undergoing single-trajectory endoscopic third ventriculostomy and endoscopic biopsy for midline tumors presenting with obstructive hydrocephalus

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Introduction. Intraventricular endoscopic surgery

Mark G. Hamilton, Ahmed K. Toma, Charles Teo, Caroline Hayhurst, and Mark Souweidane

a part of the spectrum of disorders and lesions affecting the CSF pathways. The most common neuroendoscopic procedure, endoscopic third ventriculostomy, while frequently undertaken as a sole procedure, is not addressed as a specific topic. However, there are excellent, compelling presentations that depict the use of image guidance to assist in the endoscopic management of complex hydrocephalus and a technique to expand endoscopic access to the third ventricle with the opening of the choroidal fissure. Other videos describe the fenestration of a giant arachnoid

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Resection of a pineal region papillary tumor using robotic exoscope: improved visualization and ergonomics for deep seeded tumor

Wei X. Huff, Andrew J. Witten, and Mitesh V. Shah

eyelids.” She needed to blink a lot to focus. Her physical exam revealed mild defects with accommodation and convergence. Her imaging demonstrated a pineal region heterogeneously enhancing lesion with obstructive hydrocephalus. This lesion measured 2.7 × 2.2 × 2.2 cm with areas of calcification and hemorrhage present. She underwent endoscopic third ventriculostomy (ETV) and endoscopic biopsy of the lesion. Her CSF markers were negative for germ cell tumor. Her pathology results were consistent with a papillary tumor. Our tumor board recommended surgical resection. Of

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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

can do still some job, but the pillar of the fornix is visible and it looks quite healthy, so we can just clean the boundaries of the pillar of the fornix, very nicely respecting the ependyma and respecting certainly the anterior pillar of the fornix that should not be injured by our ultrasonic aspirator. 6:45 Final Debulking and Third Ventriculostomy. Here you can see the normal ependyma on the floor of the third ventricle. The tumor fortunately is easy to recognize and to detach from the normal ependyma. And here you can see the tuber cinereum below the

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Endoscopic endonasal approach for brainstem cavernous malformation

Ezequiel Goldschmidt, Andrew S. Venteicher, Maximiliano Nuñez, Eric Wang, Carl Snyderman, and Paul Gardner

mamillary bodies come into view. Here, examination of the prior endoscopic third ventriculostomy showed lack of patency. This was dissected and slightly reopened to allow relaxation of the mamillary bodies away from the basilar apex. We can then dissect and evaluate the thalamoperforators, the basilar apex, and also see some vague discoloration in the midbrain where the cavernous malformation essentially presents to the surface. Indocyanine green angiography with the endoscope was performed to evaluate the vasculature, and again here we see the region of the mesencephalon

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Navigation guidance in neuroendoscopic management of complex hydrocephalus

Nishanth Sadashiva, Subhas Konar, Chirag Jain, and Dhaval Shukla

abdominal adhesions and hydrothorax. MRI showed hydrocephalus with aqueductal obstruction, and the floor of third ventricle appeared very thick. Right frontal burr hole was done and ventricles entered. The floor of third ventricle appeared thick and anatomy was distorted. Navigation system was used to identify the exact expected entry point for third ventriculostomy. The floor was perforated, the deeper area inspected and confirmed with navigation. Navigation had to be used again to check the entry into prepontine space. The membrane appeared very thick, so the