scholarly journals Endoscopic resection of the third ventricular epidermoid cysts: A case review and review of literature

2019 ◽  
Vol 10 ◽  
pp. 98
Author(s):  
Samir Kashyap ◽  
Bhagat Cheema ◽  
Vaninder Chhabra
Keyword(s):  
Tumor Recurrence ◽  
Third Ventricle ◽  
Gross Total Resection ◽  
Case Review ◽  
Total Resection ◽  
Transcallosal Approach ◽  
Epidermoid Cysts ◽  
Advantages And Disadvantages ◽  
The Third ◽  
Microsurgical Techniques

Background: Epidermoid cysts are benign, congenital lesions that originate from ectodermal cells, they are most commonly found in the cerebellopontine angle, but rarely in the ventricular system. There is limited literature regarding the different microsurgical techniques utilized to approach these lesions. Methods: A 63-year-old female with a recurrent third ventricular epidermoid cyst underwent gross total resection utilizing an endoscopic technique. We also reviewed the various endoscopic/microsurgical approaches and outcomes reported in literature. Results: We identified 15 cases, including our own. Nine of these were managed using microsurgical techniques, while six cases (including ours) were treated endoscopically; gross total resection was achieved in 10/15 cases (67%). Most commonly, surgeons utilized the interhemispheric transcallosal approach (five cases). Tumor recurrence was seen in two cases. Complications attributed to these resections included: disorders of the hypothalamic-pituitary axis (3) – diabetes insipidus, galactorrhea, and hypopituitarism; tumor recurrence (2); aseptic meningitis (1); and a transient Korsakoff syndrome (1). Conclusion: Epidermoid cysts of the third ventricle are exceedingly rare, and surgical resection is generally well tolerated. Microsurgical transcortical, transcallosal, and endoscopic approaches each have advantages and disadvantages, and are associated with unique procedure-specific complications. Continuing technological improvement would favor endoscopic approaches for resection of tumors of the third ventricle in the future.

scholarly journals Gross Total Resection of Chordoid Glioma of the Third Ventricle via Anterior Interhemispheric Transcallosal Transforaminal Approach at Two Stages

2018 ◽  
Vol 79 (S 03) ◽  
pp. S281-S282
Author(s):  
Ihsan Dogan ◽  
Melih Ucer ◽  
Mustafa Başkaya
Keyword(s):  
Third Ventricle ◽  
Gross Total Resection ◽  
Total Resection ◽  
Advantages And Disadvantages ◽  
Second Stage ◽  
The Third ◽  
Transforaminal Approach ◽  
Ct Angiogram ◽  
Chordoid Glioma ◽  
Third Ventricular Tumor

AbstractSuprasellar tumors in particular tumors located in the retrochiasmatic area and anterior third ventricle are challenging cases in terms of optimal surgical exposure. Several approaches have been described including transsylvian, translamina terminalis, endoscopic endonasal, and anterior interhemispheric. Each approach has advantages and disadvantages. In this video, we present a case of retrochiasmatic anterior third ventricular tumor that was operated via anterior interhemispheric transcallosal transforaminal approach. The patient is a 42-year-old female who presented with sudden onset of severe headache and depressed level of consciousness. Computed tomography (CT) scan of the head showed a hemorrhage in the third ventricle and suprasellar cisterns. CT angiogram and magnetic resonance imaging (MRI) confirmed diagnosis of hemorrhagic mass lesion in the third ventricle. Upon further questioning of her family, we found out that she was having excessive urination and short-term memory problems for last 2 weeks. First, ventriculostomy was placed for obstructive hydrocephalus. She then underwent surgical resection via anterior interhemispheric transcallosal transforaminal approach. Foramen of Monro was enlarged by performing transchoroidal dissection. Using transforaminal route, tumor was resected. Due to the narrow surgical corridor and high vascularity of the tumor, decision was made to come back at a second stage. Using same surgical approach, in the second stage, gross total resection was performed. Postoperative MRI confirmed gross total resection. Histopathology was chordoid glioma of the third ventricle. She made excellent recovery with persistent diabetes insipidus. Currently, she is completing radiation therapy. In this video, we demonstrate techniques and pitfalls of anterior interhemispheric transcallosal approach to anterior third ventricular tumor.The link to the video can be found at: https://youtu.be/CI5c6Zup8sY.

Endoscopic Resection of Hemorrhaged Third Ventricle Cavernous Malformation: 2-Dimensional Operative Video

2018 ◽  
Vol 16 (2) ◽  
pp. E51-E51
Author(s):  
Giorgio Palandri ◽  
Thomas Sorenson ◽  
Mino Zucchelli ◽  
Nicola Acciarri ◽  
Paolo Mantovani ◽  
...  
Keyword(s):  
Gold Standard ◽  
Intraventricular Hemorrhage ◽  
Cavernous Malformation ◽  
Third Ventricle ◽  
Gross Total Resection ◽  
Vascular Lesions ◽  
Total Resection ◽  
Cavernous Malformations ◽  
The Third

Abstract Cavernous malformations of the third ventricle are uncommon vascular lesions. Evidence suggests that cavernous malformations in this location might have a more aggressive natural history due to their risk of intraventricular hemorrhage and hydrocephalus.1 The gold standard of treatment is considered to be microsurgical gross total resection of the lesion. However, with progressive improvement in endoscopic capabilities, several authors have recently advocated for the role of minimally-invasive neuroendoscopy for resecting intraventricular cavernous malformations.2-4 In this timely intraoperative video, we demonstrate the gross total resection of a third ventricle cavernous malformation that presented with hemorrhage via a right-sided trans-frontal neuroendoscopic approach.

scholarly journals Surgical approaches to the third ventricle of the brain in children

2021 ◽  
Vol 11 (1) ◽  
pp. 47-54
Author(s):  
Sergey K. Gorelyshev ◽  
Olga A. Medvedeva
Keyword(s):  
Third Ventricle ◽  
Pineal Region ◽  
Anterior Horn ◽  
Surgical Approaches ◽  
Surgical Interventions ◽  
Transcallosal Approach ◽  
Advantages And Disadvantages ◽  
The Third ◽  
Lateral Ventricles ◽  
The Brain

AIM: This study aimed to describe and analyze the advantages and disadvantages of various surgical approaches to neoplasms of the third ventricle of the brain in children. MATERIALS AND METHODS: This study analyzed surgical interventions to the third ventricle in 657 patients, performed at the Academician N.N. Burdenko of the Research Institute of Neurosurgery from 1998 to 2018. These included 375 patients with intra-extraventricular craniopharyngiomas and 282 patients with gliomas of the third ventricle and chiasm. The patients age ranged from 3 mon to 18 years old. RESULTS: The anterior transcallosal approach provides access to the anterior horn and bodies of the lateral ventricles, as well as the third ventricle. The transfornical approach provides more opportunities for access to both the anterior and posterior parts of the third ventricle; however, it has a high risk of trauma to the fornix. The subchoroidal approach provides a very good view of the posterior parts of the third ventricle, especially of the pineal region; however, it has even greater restrictions on viewing its anterior parts. When compared with the transcallosal approach, the transfrontal approach can be used more safely in the absence of hydrocephalus (if the tumor is located in the anterior horn). No specific complications were inherent in a particular approach (seizures were registered in 1%, transient hemiparesis was noted in 10%, and transient memory impairments were revealed in 5% of cases). CONCLUSION: The use of a transcallosal approach is safe even in infants. The transcortical approach is recommended mainly for large tumors of the lateral ventricles, and the transcallosal approach should be used for small tumors of the third ventricle. No specific complications were inherent in a particular approach, and the choice was determined by the assessment of the exact location of the tumor and calculation of the most relevant trajectory for its achievement as well as the aim (biopsy or radical removal). Analysis of magnetic resonance imaging and neuronavigation are significant in the selection of surgical approaches.

COLLOID CYSTS OF THE THIRD VENTRICLE: A REVIEW OF SIXTEEN CASES

2021 ◽  
pp. 62-64
Author(s):  
Y Srinivas Rao ◽  
Hemal Chheda ◽  
Ch Surendra ◽  
M V Vijayasekhar ◽  
K Satya Varaprasad
Keyword(s):  
Benign Lesion ◽  
Third Ventricle ◽  
Clinical Manifestations ◽  
Colloid Cyst ◽  
Surgical Approaches ◽  
Imaging Features ◽  
Complete Excision ◽  
Advantages And Disadvantages ◽  
The Third ◽  
Colloid Cysts

BACKGROUND : Colloid cysts are one of the rare brain tumours and are mostly located in the anterosuperior portion of the third ventricle, between the fornix and surround of Foramen of Monroe. OBJECTIVES: Ÿ 1.To review the demographic information & analyse clinical manifestations of patients presenting with colloid cyst of third ventricle. Ÿ 2.To analyze the advantages and disadvantages of various surgical approaches Ÿ 3.To assess the surgical outcome in colloid cyst patients operated by any method. MATERIALS AND METHODS: A retrospective study was performed on 16 patients who presented with a colloid cyst and underwent surgery at the Department of Neurosurgery, King George Hospital, Andhra Medical College between 2013-2018. They were evaluated based on clinical ndings and imaging features, surgical approaches used for resection and their outcomes. RESULTS: Sixteen cases of colloid cyst of the third ventricle were operated upon between 2013-2018. There were seven male and nine female patients with their ages varying between 9 and 62 years old. Nine patients were operated on by using a transcortical trans-ventricular approach, four using the anterior trans-callosal approach and, three patients by using an endoscopic approach. In all patients, complete excision of the lesions was achieved. CONCLUSION: Colloid cysts, though benign, present surgical challenges because of its deep midline location. Complete excision of the colloid cyst carries an excellent prognosis. Surgery is a safe and effective treatment option for this benign lesion.

scholarly journals Microsurgical Gross Total Resection of a Large Residual/Recurrent Vestibular Schwannoma via Translabyrinthine Approach

2018 ◽  
Vol 79 (S 05) ◽  
pp. S387-S388
Author(s):  
Sima Sayyahmelli ◽  
Joseph Roche ◽  
Mustafa Baskaya
Keyword(s):  
Vestibular Schwannoma ◽  
Gross Total Resection ◽  
Subtotal Resection ◽  
Total Resection ◽  
Entry Zone ◽  
Stereotactic Radiation ◽  
Translabyrinthine Approach ◽  
History Of ◽  
Microsurgical Techniques ◽  
Facial Function

Although, gross total resection in large vestibular schwannomas is an ideal goal, subtotal resection is frequently performed due to lack of expertise, concerns for facial palsy, or overuse of stereotactic radiation. In this video, we present a 31-year-old man with a 7-year history of tinnitus, dizziness, and hearing loss. The patient had a subtotal resection of a 2.5 cm right-sided vestibular schwannoma via retrosigmoid craniotomy at an outside hospital. He was referred for further surgical resection due to the increased size of the tumor on surveillance magnetic resonance imagings (MRIs) and worsening symptoms. MRI showed a residual/recurrent large schwannoma with extension to the full length of the internal acoustic canal and brain stem compression. He underwent microsurgical gross total resection via a translabyrinthine approach. The facial nerve was preserved and stimulated with 0.15 mA at the brainstem entry zone. He awoke with House–Brackmann grade III facial function, with an otherwise uneventful postoperative course. In this video, microsurgical techniques and important resection steps for this residual/recurrent vestibular schwannoma are demonstrated, and nuances for microsurgical technique are discussed.The link to the video can be found at: https://youtu.be/a0ZxE41Tqzw.

scholarly journals Expanded Transsphenoidal Trans-Lamina Terminalis Approach to Tumors Extending Into the Third Ventricle: Technique Notes and a Single Institute Experience

2021 ◽  
Vol 11 ◽  
Author(s):  
Lei Cao ◽  
Wentao Wu ◽  
Jie Kang ◽  
Hui Qiao ◽  
Xiaocui Yang ◽  
...  
Keyword(s):  
Cavernous Malformation ◽  
Third Ventricle ◽  
Radical Resection ◽  
Lamina Terminalis ◽  
Total Resection ◽  
The Third ◽  
Cerebrospinal Fluid Leaks ◽  
Ventricular Tumors ◽  
New Onset

ObjectThe trans lamina terminalis approach (TLTA) has been described as a way to remove third ventricular tumors. The aim of this paper was to analyze the feasible outcomes of TLTA applied to tumors extending into the third ventricle in our institute.MethodsSuprasellar tumors (n = 149) were treated by the extended endonasal approach from September 2019 to December 2020 in Beijing Tiantan Hospital. Eleven of the tumors were treated by TLTA or TLTA via the trans-chiasm-pituitary corridor (TCPC). The surgical technique notes of TLTA were described and indications and outcomes of the approach were analyzed.ResultsThere were 11 patients enrolled in the study, six with papillary craniopharyngiomas, two with adamantinomatous craniopharyngiomas, one with a germinal cell tumor (GCT), one with cavernous malformation and one with chordoid glioma. Four of the patients received a radical resection by TLTA alone, while seven of them received TLTA via the TCPC. Gross total resection was achieved in eight patients (72.7%), and partial resection in three patients (27.3%). Visual function was improved in four of the 11 patients (36.4%), was unchanged in five patients (45.5%), and deteriorated in two patients (18.2%). New-onset hypopituitarism occurred in seven patients (63.3%) and new-onset diabetes insipidus occurred in two patients (18.2%). Electrocyte imbalance were observed in six patients (54.5%) at post-operative week 2. There were no surgery-related deaths or cerebrospinal fluid leaks. Postoperative intracranial infection was observed in one patient (9.1%), and during the follow-up period, tumor recurrence occurred in one patient (9.1%).ConclusionThe expanded TLTA provides a feasible suprachiasm corridor to remove tumors extending into the third ventricle, especially for craniopharyngiomas. Sound understanding of the major strengths and limitations of this approach, as well as strategies for complication avoidance, is necessary for its safe and effective application.

The impact of adjuvant stereotactic radiosurgery on atypical meningioma recurrence following aggressive microsurgical resection

2013 ◽  
Vol 119 (2) ◽  
pp. 475-481 ◽  
Author(s):  
Douglas A. Hardesty ◽  
Andrew B. Wolf ◽  
David G. Brachman ◽  
Heyoung L. McBride ◽  
Emad Youssef ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Stereotactic Radiosurgery ◽  
Recurrence Rate ◽  
Tumor Recurrence ◽  
Gross Total Resection ◽  
Adjuvant Radiation ◽  
Total Resection ◽  
Microsurgical Resection ◽  
Atypical Meningiomas

Object Patients with atypical meningioma often undergo gross-total resection (GTR) at initial presentation, but the role of adjuvant radiation therapy remains unclear. The increasing prevalence of stereotactic radiosurgery (SRS) in the modern neurosurgical era has led to the use of routine postoperative radiation therapy in the absence of evidence-based guidelines. This study sought to define the long-term recurrence rate of atypical meningiomas and identify the value of SRS in affecting outcome. Methods The authors identified 228 patients with microsurgically treated atypical meningiomas who underwent a total of 257 resections at the Barrow Neurological Institute over the last 20 years. Atypical meningiomas were diagnosed according to current WHO criteria. Clinical and radiographic data were collected retrospectively. Results Median clinical and radiographic follow-up was 52 months. Gross-total resection, defined as Simpson Grade I or II resection, was achieved in 149 patients (58%). The median proliferative index was 6.9% (range 0.4%–20.6%). Overall 51 patients (22%) demonstrated tumor recurrence at a median of 20.2 months postoperatively. Seventy-one patients (31%) underwent adjuvant radiation postoperatively, with 32 patients (14%) receiving adjuvant SRS and 39 patients (17%) receiving adjuvant intensity modulated radiation therapy (IMRT). The recurrence rate for patients receiving SRS was 25% (8/32) and for IMRT was 18% (7/39), which was not significantly different from the overall group. Gross-total resection was predictive of progression-free survival (PFS; relative risk 0.255, p < 0.0001), but postoperative SRS was not associated with improved PFS in all patients or in only those with subtotal resections. Conclusions Atypical meningiomas are increasingly irradiated, even after complete or near-complete microsurgical resection. This analysis of the largest patient series to date suggests that close observation remains reasonable in the setting of aggressive microsurgical resection. Although postoperative adjuvant SRS did not significantly affect tumor recurrence rates in this experience, a larger cohort study with longer follow-up may reveal a therapeutic benefit in the future.

DIZYGOTIC TWINS WITH A COLLOID CYST OF THE THIRD VENTRICLE

Neurosurgery ◽  
2008 ◽  
Vol 63 (5) ◽  
pp. E1003-E1003 ◽  
Author(s):  
Rossana Romani ◽  
Mika Niemelä ◽  
Miikka Korja ◽  
Juha A. Hernesniemi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Obstructive Hydrocephalus ◽  
Third Ventricle ◽  
Colloid Cyst ◽  
Resonance Imaging ◽  
Transcallosal Approach ◽  
The Third ◽  
Familial Cases ◽  
Colloid Cysts

Abstract OBJECTIVE AND IMPORTANCE Colloid cysts of the third ventricle are rare benign tumors of endodermal origin accounting for 1% of all intracranial tumors. Interestingly, a few familial cases have been reported previously. We present the first case of dizygotic twins with a symptomatic colloid cyst of the third ventricle. CLINICAL PRESENTATION A 10-year-old boy was admitted to a local hospital in 1993 because of severe progressive headache. Computed tomographic and magnetic resonance imaging scans revealed acute obstructive hydrocephalus attributable to a third ventricular colloid cyst, which was removed after emergent ventricular drainage. Fourteen years later, a nonidentical twin brother complained of continuous headache with nausea and vomiting. A magnetic resonance imaging scan showed obstructive hydrocephalus and a third ventricle colloid cyst, which was removed by use of the transcallosal approach. INTERVENTION Both twins underwent complete removal of the cyst by the interhemispheric transcallosal approach without postoperative complications. CONCLUSION On the basis of a literature review, 2 cases of colloid cysts of the third ventricle in monozygotic twins and a few familial cases have been reported. Our case is the first in dizygotic twin brothers. These findings suggest that the prevalence of colloid cyst may be higher in twins than in the general population. We believe that the presence of this lesion in a twin necessitates magnetic resonance imaging of the other twin, and a clinical follow-up would be recommended in all other first-degree relatives.

Technical strategies for the transcallosal transforaminal approach to third ventricle tumors: expanding the operative corridor

2014 ◽  
Vol 14 (4) ◽  
pp. 365-371 ◽  
Author(s):  
Prayash Patel ◽  
Aaron A. Cohen-Gadol ◽  
Frederick Boop ◽  
Paul Klimo
Keyword(s):  
Short Term Memory ◽  
Third Ventricle ◽  
Signs And Symptoms ◽  
Surgical Approaches ◽  
Easy Method ◽  
Foramen Of Monro ◽  
Advantages And Disadvantages ◽  
The Third ◽  
Transforaminal Approach ◽  
Common Group

Object There are a number of surgical approaches to the third ventricle, each with advantages and disadvantages. Which approach to use depends on the location of the lesion within the ventricle, the goals of the operation, and the surgeon's experience. The authors present their results in children with a modified approach through the expanded foramen of Monro. Methods A retrospective study was conducted to identify and analyze all children who underwent what the authors term the “expanded transforaminal” approach to the third ventricle between 2010 and 2013. Perioperative data included patient demographics, signs and symptoms on presentation, tumor characteristics (type, origin, and size), complications, and clinical and radiographic outcome at final follow-up. Results Twelve patients were identified (5 female, 7 male) with a mean age of 9 years (range 2–19 years). Two patients underwent gross-total resections, whereas 10 resections were less than total. There were no instances of venous infarction, significant intraoperative bleeding, or short-term memory deficits. Of the 12 patients, 7 suffered a total of 17 complications. Disruption of neuroendocrine function occurred in 4 patients: 2 with transient diabetes insipidus, 2 with permanent panhypopituitarism, and 1 with central hypothroidism (1 patient had 2 complications). The most common group of complications were CSF-related, including 2 patients requiring a new shunt. There was 1 approach-related injury to the fornix, which did not result in any clinical deficits. One child with an aggressive malignancy died of tumor progression 6 months after surgery. Of the remaining 11 patients, none have experienced tumor recurrence or progression to date. Conclusions The expanded transcallosal transforaminal approach is a safe and relatively easy method of exploiting a natural pathway to the third ventricle, but there remain blind zones in the anterosuperior and posterosuperior regions of the third ventricle.

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