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Endoscopic third ventriculostomy and biopsy of a tectal lesion using flexible neuroendoscopy and urological cup forceps: illustrative case

Meredith Yang, Daniel Wolfson, Melissa A. LoPresti, Emma Poland, Sandi Lam, and Michael DeCuypere

influence decision making. Thus, treatment goals for symptomatic tumors are twofold: CSF diversion and tissue diagnosis. Methods of sampling pineal region tumors include open biopsy or, more recently, endoscopic biopsy. 2 First described in 1997 while using a flexible neuroendoscope, 3 simultaneous endoscopic third ventriculostomy (ETV) and biopsy through a single burr hole has been demonstrated to be safe and diagnostically efficacious, allowing surgeons to procure tissue and treat hydrocephalus in one procedure. Herein, we describe our experience with single burr

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Symptomatic obstructive hydrocephalus caused by choroid plexus hyperplasia in a pediatric patient: illustrative case

Ana Sofia Alvarez, John P McGinnis, Rajan Patel, and Howard L Weiner

choroid plexus hyperplasia. The radiologist was concerned about a possible tumor. MRI of the spine did not show any significant findings. FIG. 1 Preoperative postcontrast sagittal T1-weighted MRI showing obstruction of the aqueduct of Sylvius by the choroid plexus. FIG. 2 Preoperative postcontrast axial T1-weighted MRI showing supratentorial hydrocephalus. Given the clinical and radiological findings, endoscopic third ventriculostomy (ETV) was indicated. The surgery was performed through a standard right frontal burr hole, and intraoperative ultrasound

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Removal of a flanged ventricular catheter: illustrative case

M. Benjamin Larkin, Tyler T. Lazaro, Howard L. Weiner, and William E. Whitehead

completing the antibiotic schedule, the patient went to the operating room for another attempt at removing the retained flanged catheter under endoscopic visualization followed by endoscopic third ventriculostomy (ETV). The flanged catheter was visualized in the body of the right lateral ventricle with minimal scarring. The right occipital incision was opened, and the distal end of the proximal flanged catheter was exposed. The catheter was slowly removed from the tethered portion of the choroid plexus using flexible wire monopolar electrocautery, gentle rotation, and

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Transventricular endoscopic approach to the anterior interhemispheric fissure for neurocysticercosis: illustrative cases

Mao Vásquez, Luis J. Saavedra, Hector H. García, Alejandro Apaza, Yelimer Caucha, Jorge E. Medina, Dennis Heredia, Fernando Romero, and William W. Lines-Aguilar

. Surgery We used a Storz device for ventricular endoscopy, approaching through the right Kocher’s point with a trephine, in the same projection as for an endoscopic third ventriculostomy (ETV) once in the right lateral ventricle the thalamus-striate vein, choroid plexus, and the protrusion at the floor of the lateral ventricle produced by the NCC cysts in the AIF ( Fig. 2 ), which was fenestrated with bipolar coagulation up to the AIF ( Fig. 2 ). From here, some cysts began to appear and were removed with a Nelaton #8 probe, which allowed us to extract a greater volume

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Endoscopic resection of a giant colloid cyst in the velum interpositum: illustrative case

Mahdi Arjipour, Mohammad Gharib, and Mohamadmehdi Eftekharian

into consideration. Operation The patient underwent surgery through an endoscopic approach to the lesion. After entering the ventricular space from the right side, the lesion was observed. At first, a cerebrospinal fluid sample was taken and an endoscopic third ventriculostomy was undertaken for hydrocephalus treatment. Then, after the mass wall opening at the superior part, there was a firm nonsuctionable solid gray-yellow material inside the lesion, which was not typical for a colloid cyst. Thus, the solid lesion content was resected in a piecemeal manner

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Immunocompetent isolated cerebral mucormycosis presenting with obstructive hydrocephalus: illustrative case

Khoa N Nguyen, Lindsey M Freeman, Timothy H Ung, Steven Ojemann, and Fabio Grassia

to red blood cells (2,000) on cell count. The differential resulted in 8% neutrophils, 65% lymphocytes, and 27% monocytes. Cultures were negative. Four days later, the patient underwent planned endoscopic third ventriculostomy (ETV). An intraoperative decision was made to also complete an endoscopic biopsy. Induction of general anesthesia, endotracheal intubation, and patient head fixation in a neutral 30° elevated position were completed in typical fashion. After the usual surgical preparation, a right frontal burr hole was made at Kocher’s point, and the dura

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Endoscopic placement of a triventricular stent for complex hydrocephalus and isolated fourth ventricle: illustrative case

V. Jane Horak, Beste Gulsuna, Melissa A LoPresti, and Michael DeCuypere

revising the article: all authors. Reviewed submitted version of manuscript: all authors. Approved the final version of the manuscript on behalf of all authors: DeCuypere. Administrative/technical/material support: Horak. Study supervision: DeCuypere. References 1 Ferrer E , de Notaris M . Third ventriculostomy and fourth ventricle outlets obstruction . World Neurosurg . 2013 ; 79 ( 2 Suppl ): S20.e9 – e13 . 2 Bock HC , Dreha-Kulaczewski SF , Alaid A , Gärtner J , Ludwig HC . Upward movement of cerebrospinal fluid in