Articles: third-ventricle-surgery.
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Although endoscopic approaches are widely used for resection of colloid cysts because of the lower invasiveness, removal of the recurrent colloid cyst is still challenging. Total removal is sometimes difficult to achieve with single-port endoscopy because of the restricted access and working space. To compensate for these limitations, the dual endoscope technique via the bilateral transforaminal approach was chosen. ⋯ The dual endoscope technique via the bilateral transforaminal approach can achieve better surgical outcome by obtaining direct visualization of the cyst attachment. Although the indication should be limited, this approach can be considered especially for patients with recurrent lesions involving possible adhesion to vital structures.
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Case Reports
Endoscopic Transforaminal Transchoroidal (ETTC) Approach to the Third Ventricle for Cystic and Solid Tumors.
Endoscopic access to the third ventricle is limited by the confinements of the foramen of Monro and can be aided by opening of the choroidal fissure. ⋯ ETTC approach is a safe and effective method for enlargement of the foramen of Monro. The approach improves maneuverability of the endoscope and allows a broad range of movement and increased angulation within the foramen of Monro. Attention to anatomy is paramount to avoid injury to the venous structures and fornix.
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Review Case Reports
Choroid plexus carcinoma in adults: literature review and first report of a location into the third ventricle.
Choroid plexus carcinoma (CPC) is a rare intraventricular neoplasm originating from choroid plexus. CPC is the most aggressive choroid plexus tumor. Almost all the CPCs are detected in children, and the preferred location is the lateral ventricle. ⋯ Gross total resection should be the first step of the treatment: however, according to the literature, gross total resection is achieved only in 40-75% of cases in CPC as opposed to 95% in choroid plexus papilloma, mainly due to the difficulty in managing a highly vascularized tumor in such a deep location. Chemotherapy has not an established role and adjuvant treatment is based on radiotherapy. In the case described hereby the gross total resection associated with surgical treatment of hydrocephalus and adjuvant radiotherapy has achieved a good clinical and radiological outcome.
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Case Reports
An alternative route to the posterior half of the third ventricle: the trans-occipital horn approach. Technical note.
Lesions arising or abutting in the posterior half of the third ventricle are approached through established routes to avoid damage of essential brain structures. Occasionally, the features of the lesion require rethinking these traditional routes and tailoring the surgical approach to cause fewer debilitating sequelae to the patient. We introduce a modification of previously described transcortical approaches to lesions of the posterior third ventricle. The technique and possible indications are discussed. ⋯ The transoccipital horn approach is a feasible alternative to other surgical routes to the posterior part of the third ventricle in cases of particularly challenging anatomy and tumor characteristics. It allows reaching the lesion along its major axis, fully exploiting the natural space created by the tumor in its growth and avoiding the internal cerebral veins.
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Case Reports
Positive outcome of endoscopic third ventriculostomy in fourth ventricular outlet obstruction.
We report a case of headache due to a hydrocephalus with associated syringomyelia. Magnetic resonance imaging showed a fourth ventricular outlet obstruction. ⋯ As far as we know, there are few reports that propose ETV as treatment. Therefore our case supports that ETV could be a successful option for the management of this condition.