Neuroendoscopy in pineal region tumor with obstructive hydrocephalus

2000 ◽  
Vol 4 (4) ◽  
pp. 154-158 ◽  
Author(s):  
Danny Tat-Ming Chan ( ) ◽  
Joseph Ming-Kuen Lam ( ) ◽  
Wai-Sang Poon ( )
Keyword(s):  
Obstructive Hydrocephalus ◽  
Pineal Region ◽  
Pineal Region Tumor

scholarly journals Retractorless surgery for a pineal region tumor through an occipital transtentorial approach

2016 ◽  
Vol 40 (videosuppl1) ◽  
pp. 1
Author(s):  
Naoyuki Nakao
Keyword(s):  
Visual Cortex ◽  
Tissue Injury ◽  
Obstructive Hydrocephalus ◽  
Surgical Techniques ◽  
Pineal Region ◽  
Pineal Region Tumor ◽  
Working Space ◽  
Occipital Transtentorial Approach ◽  
The Brain ◽  
Transtentorial Approach

This video demonstrates surgical techniques of the occipital transtentorial approach to a pineal region tumor without using a fixed brain retractor, which may cause functional impairment or even tissue injury to the occipital visual cortex. There are several ways to facilitate retractorless surgery through this approach. A lateral-semiprone positioning of the patient can induce gravity retraction. The brain is relaxed by draining CSF fluid through lumbar drainage or lateral ventricular tap in the case of obstructive hydrocephalus. Dynamic retraction with handheld instruments after extensive dissection of the deep venous system, including basal veins, can provide a sufficient working space.The video can be found here: https://youtu.be/kQvEHiNcRow.

scholarly journals Human Midbrain Auditory Evoked Potentials Do Not Differ Between Bursts and Suppressions of Cortex Activity in Propofol Anesthesia: Case Report

2020 ◽  
Vol 5 (02) ◽  
Author(s):  
Anna O. Kantserova ◽  
Lyubov B. Oknina ◽  
Eugeny L. Masherov ◽  
Vitaly V. Podlepich ◽  
Maria I. Kamenetskaya ◽  
...  
Keyword(s):  
Evoked Potentials ◽  
General Anesthesia ◽  
Auditory Evoked Potentials ◽  
Obstructive Hydrocephalus ◽  
Pineal Region ◽  
Cerebral Aqueduct ◽  
Pineal Region Tumor ◽  
Transcallosal Approach ◽  
Total Length ◽  
Significant Difference

Propofol, the most widely administered anesthetic agent, is used for sedation and general anesthesia. During general anesthesia it can induce bursts and suppressions of cortex activity, which exact mechanism of generation has not been identified yet. The aim of study was to investigate the difference between midbrain auditory evoked potentials recorded during bursts and suppressions of cortex activity. These potentials were registered from the drainage-electrode implanted in the cerebral aqueduct of an adult patient with an obstructive hydrocephalus who had undergone pineal region tumor removal through anterior interhemispheric transcallosal approach. The cortex activity was divided into rare bursts of alpha activity (total length of 9 seconds) and prolonged suppressions (total length of 104 seconds). Midbrain auditory evoked potentials included long latency peaks with no statistically significant difference in their amplitudes and latencies between bursts and suppressions of cortex activity. The results suggest that human midbrain auditory evoked potentials do not differ between bursts and suppressions of cortex activity in propofol anesthesia. Therefore, for clear midbrain auditory evoked potentials cognitive but not the total electrical activity of the cortex should be suppressed.

scholarly journals Our Experience with Infratentorial Supracerebellar (ITSC) Approach for Pineal Region Tumor Excision

2016 ◽  
Vol 12 (1) ◽  
pp. 38-39
Author(s):  
Gopal R Sharma ◽  
Prakash Bista ◽  
Nilam Khadka ◽  
Rajiv Jha ◽  
Maya Bhattachan ◽  
...  
Keyword(s):  
Obstructive Hydrocephalus ◽  
Air Embolism ◽  
Pineal Region ◽  
Treatment Modalities ◽  
Surgical Approaches ◽  
Good Recovery ◽  
Total Resection ◽  
Pineal Region Tumor ◽  
Pineal Region Tumors

Pineal region tumors are rare and their incidence is less than 1% of primary CNS tumors. Varieties of tumors can be found in pineal region ranging from benign to malignant pathology. Treatment modalities ranged from biopsy to total excision of tumor. Many surgical approaches have been described in the literature, however, infratentorial supracerebellar ( ITSC ) approach is versatile and widely used by many neurosurgeons worldwide.The aim of this study is to analyze and discuss the surgical outcome of pineal region tumor using ITSC approach. Advantages and limitations of this approach will be discussed.This is a retrospective study of 10 patients who underwent microsurgical excision of pineal region masses using ITSC approach in sitting position under general anesthesia at our institute between April 2009 and March 2014. The follow up period ranged from 7 months to 5 years and outcome was measured with GOS (Glasgow Outcome Scale).There were 9 male and 1 female and age ranged from 10 to 50 years.Gross total resection was performed in all 10 cases using ITSC approach. 9 patients required VP shunt for obstructive hydrocephalus. 60% (6) had benign and 40% (4) had malignant pathology.Six patients suffered from postoperative complications which included air embolism ,pneumocephalus, pseudomeningocele and seizure.Eighty percent (8) have good recovery, 1 was severely disabled and 1 died.Advanced neurological techniques combined with neuroanesthesia, neuroimaging and postoperative critical care methods have made aggressive surgical resection a mainstay of management of pineal region tumors with excellent results.Nepal Journal of Neuroscience 12:31-37, 2015

scholarly journals Interhemispheric transcallosal intervenous approach to a pineal region tumor

2021 ◽  
Vol 5 (1) ◽  
pp. V11
Author(s):  
Daniel A. Donoho ◽  
Guillermo Aldave
Keyword(s):  
Extent Of Resection ◽  
Pineal Region ◽  
Cerebral Veins ◽  
Surgical Morbidity ◽  
Pineal Tumors ◽  
Pineal Region Tumor ◽  
Pineal Region Tumors ◽  
Transcallosal Approach ◽  
Formidable Challenge ◽  
The Right

Pineal region tumors represent a formidable challenge to the neurosurgeon. Choosing the right approach is key to optimizing the extent of resection and minimizing surgical morbidity. In this video, the authors show an interhemispheric transcallosal approach to a pineal region tumor in a 15-year-old boy. The advantage of this corridor over posterior approaches is that it provides a nice view of the tumor plane with the venous complex, especially while dissecting tumor from the anterior aspect of the internal cerebral veins on their vertical path. Thus, this approach represents a safe and effective alternative for selected pineal tumors. The video can be found here: https://stream.cadmore.media/r10.3171/2021.4.FOCVID2120.

Diurnally fluctuating frontal dysequilibrium secondary to a pineal pilocytic astrocytoma: is this symptom associated with a check-valve mechanism in a pineal region tumor?

2008 ◽  
Vol 25 (3) ◽  
pp. 367-371 ◽  
Author(s):  
Tae-Won Kim ◽  
Tae-Kyu Lee ◽  
Bum-Soo Kim ◽  
Kwang-Soo Lee ◽  
In-Uk Song ◽  
...  
Keyword(s):  
Pilocytic Astrocytoma ◽  
Check Valve ◽  
Pineal Region ◽  
Valve Mechanism ◽  
Pineal Region Tumor

scholarly journals Papillary tumor of the pineal region in a 15-month-old boy

2011 ◽  
Vol 7 (5) ◽  
pp. 534-538 ◽  
Author(s):  
Jessica Li ◽  
Pablo F. Recinos ◽  
Brent A. Orr ◽  
Peter C. Burger ◽  
George I. Jallo ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Proton Beam Therapy ◽  
Pineal Region ◽  
Biological Behavior ◽  
Imaging Diagnosis ◽  
Papillary Tumor ◽  
Distinct Entity ◽  
Pineal Region Tumor ◽  
Appropriate Treatment

The papillary tumor of the pineal region (PTPR) is a distinct entity that is particularly rare in the pediatric population. The authors document the youngest reported patient with this clinicopathological entity to date. A case of PTPR in a 15-month-old boy is described. Initially thought to be a tectal glioma, the tumor was later identified as a pineal region tumor after demonstrating growth on routine imaging. Diagnosis of PTPR was established by histopathological evaluation of biopsy samples, which revealed papillary, cystic, and solid tumor components. The patient's postoperative course was complicated by tumor growth despite several debulking procedures and chemotherapy, as well as persistent hydrocephalus requiring 2 endoscopic third ventriculostomies and eventual ventriculoperitoneal shunt placement. After a 15-month follow-up period, the patient has received proton-beam therapy and has a stable tumor size. The PTPR is a recently described tumor of the CNS that must be included in the differential diagnosis of pineal region masses. The biological behavior, prognosis, and appropriate treatment of PTPR have yet to be fully defined.

Gamma Knife Radiosurgery in the Treatment of Pineal Region Tumor

1999 ◽  
pp. 227-231
Author(s):  
L. Junchao ◽  
W. Hongxun ◽  
X. Xin ◽  
L. Lin ◽  
Q. Ziheng ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Pineal Region ◽  
Pineal Region Tumor

Primary extraskeletal osteosarcoma in the pineal region

2004 ◽  
Vol 101 (6) ◽  
pp. 1061-1064 ◽  
Author(s):  
Prajak Saesue ◽  
Ekawut Chankaew ◽  
Orasa Chawalparit ◽  
Nollaporn Sudasna Na Ayudhya ◽  
Sorranart Muangsomboon ◽  
...  
Keyword(s):  
Tumor Cells ◽  
Bone Structure ◽  
Postoperative Radiotherapy ◽  
Obstructive Hydrocephalus ◽  
Pineal Region ◽  
Partial Resection ◽  
Tumor Control ◽  
Extraskeletal Osteosarcoma ◽  
Content Type ◽  
Imaging Results

✓ Primary extraskeletal osteosarcoma occurring in the brain parenchyma is distinctly uncommon, with only five cases having been reported. The authors describe the case of a 45-year-old man who presented with progressive headache and diplopia. Computerized tomography scanning and magnetic resonance imaging results revealed a pineal region tumor with obstructive hydrocephalus. The patient underwent partial resection of the tumor. The histological examination showed large pleomorphic tumor cells embedded in osteoid matrix. Immunohistochemical analysis was negative for various antibodies and thus excluded a glial, germ cell, epithelial, and lymphoid tumor origin. Only vimentin showed strong positivity in most of the tumor cells. Ultrastructurally, the tumor cells were rich in dilated rough endoplasmic reticula. Clear zones between tumor cells and osteoid matrix were observed. The osteoid matrix was made up of small collagen fibrils and hydroxyapatite deposits. The tumor was not attached to the bone structure of the skull. These findings are consistent with the features of extraskeletal osteosarcoma. Data from complete medical and radiological studies excluded a metastatic origin for this tumor. Partial resection and postoperative radiotherapy had provided tumor control at 11 months after the onset of symptoms. This is the first reported case of a primary extraskeletal osteosarcoma occurring in the pineal region.

scholarly journals Malignant Rhabdoid Tumour of the Pineal Region

1994 ◽  
Vol 21 (3) ◽  
pp. 273-277 ◽  
Author(s):  
Matthew Muller ◽  
Sherri Lynn Hubbard ◽  
John Provias ◽  
Mark Greenberg ◽  
Laurence E. Becker ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Obstructive Hydrocephalus ◽  
Signs And Symptoms ◽  
Pineal Region ◽  
Mass Lesion ◽  
Raised Intracranial Pressure ◽  
Pathological Features ◽  
Rhabdoid Tumour ◽  
Intratumoral Hemorrhage ◽  
The Central Nervous System

Abstract:A 9-month-old male presented to hospital with signs and symptoms of raised intracranial pressure. A CT scan showed obstructive hydrocephalus from a large pineal region mass lesion into which an intratumoral hemorrhage had occurred. A posterior fossa craniectomy and subtotal excision of the mass lesion were performed. By histopathology, the lesion was a malignant rhabdoid tumour (MRT). Despite surgery and chemotherapy, the tumour grew inexorably, and the patient died four months after the initial diagnosis. MRT is a rare and highly invasive neoplasm which infrequently arises from the central nervous system. This is the first documented case of a MRT arising from the pineal region. The clinical, radiographic, and pathological features of the MRT in this patient are presented.

INTRAOPERATIVE DIRECT THIRD VENTRICULOSTOMY AND AQUEDUCTAL STENTING IN DEEP-SEATED MIDLINE BRAIN TUMOR SURGERY

Neurosurgery ◽  
2009 ◽  
Vol 64 (2) ◽  
pp. 256-267 ◽  
Author(s):  
David I. Pitskhelauri ◽  
Alexander N. Konovalov ◽  
Valeri N. Kornienko ◽  
Natalia K. Serova ◽  
Nikita V. Arutiunov ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Obstructive Hydrocephalus ◽  
Third Ventricle ◽  
Pineal Region ◽  
Third Ventriculostomy ◽  
Success Rates ◽  
Tumor Removal ◽  
The Third ◽  
Total Tumor Removal ◽  
Ventricular Shunting

Abstract OBJECTIVE Surgical resection of deep-seated midline brain tumors does not always resolve obstruction of cerebrospinal fluid pathways, and an additional operation—ventricular shunting—is required. To prevent postoperative obstructive hydrocephalus, we combine tumor removal and internal ventricular shunting in 1 stage. METHODS Between 2000 and 2006, 82 patients with deep-seated midline brain tumors (tumors of the third ventricle, pineal region, thalamus, upper brainstem, and superior half of the fourth ventricle) underwent 84 tumor resections with intraoperative internal ventricular shunting. Two types of intraoperative shunting were performed: direct third ventriculostomy with fenestration of the premammillary membrane of the third ventricle floor and Liliequist's membrane, 53 operations; and aqueductal stenting, 30 operations. In 1 patient, third ventriculostomy and aqueductal stenting were performed simultaneously. RESULTS As most of the tumors had an infiltrative growth pattern, gross total tumor removal was achieved in only 31% of patients in this series. There were no fatal outcomes related to the surgery. Follow-up data were collected in 73 patients (89%) and ranged from 2 to 68 months (median, 16 months). Additional shunting because of inadequate function of stoma or stent was performed in 13 patients at various times after surgery (median, 30 days). The Kaplan-Meier survival analysis demonstrated that at 12 and 24 months the intraoperative direct third ventriculostomy success rates were 67 and 61%, respectively; aqueductal stenting success rates were 93% at both 12 and 24 months. CONCLUSION Intraoperative direct third ventriculostomy and aqueductal stenting under direct visual control were found to be reliable methods of hydrocephalus management in patients with deep-seated midline brain tumors.

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