An observation of the third ventricle under flexible fiberoptic ventriculoscope: Normal structure

Oka, Kazunari; Go, Yoshinori; Kin, Yoshiaki; Tomonaga, Masamichi

doi:10.1016/0090-3019(93)90137-p

Cited by 26 publications

(15 citation statements)

References 6 publications

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“…[1][2][3][4][6][7][8][9][10][11][12][13][14][15][16] With the availability of MR imaging, tectal tumors are revealed more frequently in adolescents and adults who present with supratentorial hydrocephalus. The clinical presentation of raised intracranial pressure secondary to hydrocephalus in the absence of brainstem signs is characteristic of tectal tumors.…”

Section: Discussionmentioning

confidence: 99%

Neuroendoscopic approach to tectal tumors: a consecutive series

Oka¹,

Kin²,

Go³

et al. 1999

FOC

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The authors report a consecutive series of 10 patients who presented with signs and symptoms caused by tectal tumors. Clinical findings, radiographic features, neuroendoscopic management strategies, and histological findings are reported and discussed. Since January 1990, 11 neuroendoscopic procedures were performed in 10 patients who harbored tectal tumors. The patients were followed for an average of 5 years (range 2 months to 12 years), and a retrospective study was conducted in which case notes, radiological findings, operative notes, and histopathological findings were assessed. Magnetic resonance (MR) imaging was performed, and the images were used to classify patients into three groups: those with hypertrophy of the tectum in whom isointensity appeared on T1-weighted images (Group 1); those with a tectal tumor occupying the cerebral aqueduct in whom decreased signal intensity appeared on T1-weighted images, as well as no enhancement after gadolinium administration (Group 2); and those with a tectal tumor in whom mixed signal intensity appeared on T1-weighted images and conspicuous evidence of contrast enhancement (Group 3). The results of histological examination were consistent with MR imaging features: in Group 1, glial tissue or gliosis; in Group 2, benign astrocytoma; and in Group 3, malignant astrocytoma. Cerebrospinal fluid diversion was the only surgical treatment that provided relief from obstructive hydrocephalus. One patient in Group 3 underwent radiotherapy and subsequent partial tumor removal under neuroendoscopic guidance. Thereafter, the tumor remained in decline. All patients had normal intellectual status after undergoing surgery in which a neuroendoscope was used. Neuroendoscopic procedures can provide histological diagnosis, define the tumor-midbrain interrelationship, and be highly effective in treating obstructive hydrocephalus and in removing tectal tumors. This procedure may receive clinical application as a new management strategy for tectal glioma.

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Section: Discussionmentioning

confidence: 99%

Neuroendoscopic approach to tectal tumors: a consecutive series

Oka¹,

Kin²,

Go³

et al. 1999

FOC

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“…This model provides a good overview for endoscopic navigation and has been widely used to determine the feasibility of viewing the anatomical structures in the brain and basal cisterns through rigid or flexible endoscopes. [7,11,13,14,17] However, the cerebellar atrophy in the cadaver brain enlarges the basal cisterns, which facilitates neuroendoscopic navigation. The basal cisterns in cadaver brains were larger than those found in vivo.…”

Section: Discussionmentioning

confidence: 99%

“…[11] Most current clinical applications of neuroendoscopy concern the ventricular system. [2,3,6,14] The few reports on its use in the basal cistern have mostly involved cadaveric studies. [7,13,15] However, it would be of considerable interest to explore the whole CPA endoscopically, because it would enable examination of many internal sites with minimal trauma.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic anatomy of the cerebellopontine angle: a study in cadaver brains

Chaynes¹,

Deguine²,

Moscovici³

et al. 1998

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The increasing trend toward performing minimally invasive neurosurgery may benefit from recent progress in using neuroendoscopic techniques to reduce trauma in patients who have undergone operations. Arterial and venous vessels, especially loops, may compress the central segment and cause hyperactive dysfunction of the nerves. Relationships of the anterior inferior cerebellar artery to the facial and vestibulocochlear nerves and the anterior inferior, and superior cerebellar arteries to the trigeminal nerve were studied. The authors report findings from an endoscopic study performed in cadaver heads via the retrosigmoid and retrolabyrinthine approaches. Arteries and veins were colored by injection of red and blue silicon rubber. The cerebellopontine angle (CPA) was examined using 2.7-mm and 4-mm-diameter rigid endoscopes at viewing angles of 0š, 30š, and 70š. Well-known structures could be identified endoscopically without prior dissection, and the entire CPA could be explored. However, with a retrosigmoid or a retrolabyrinthine approach, the cerebellum had to be retracted to some extent to view the CPA. Moreover, wide dural exposure was required to maneuver the endoscope freely in the CPA. Use of the rigid fiberoptic endoscope is not yet superior to standard surgical techniques for approaching and exploring the CPA.

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“…When the objective is to treat the hydro c e-phalus, a rigid endoscope can be utilized to perf o rm a third ventriculostomy, as we described, with no major technical complications; the visibility of the inner s u rface of the third ventricle, with all stru c t u res involved is very good 22 .…”

Section: Discussionmentioning

confidence: 99%

Tectal plate tumors

Lázaro¹,

Landeiro²

2006

Arq. Neuro-Psiquiatr.

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A B S T R A C T -Tectal plate is a rare location for a tumor. Many papers have described diff e rent types of pathology arising in that location including tumors, vascular lesions, inflamatory and infectious processes. In this paper we describe our experience in treating seven patients with tectal plate lesions, with different ages and types of pathology: five patients presented with low grade gliomas, one with lung cancer metastasis and the last presenting with a tectal plate cavernoma. Open surg e ry was perf o rmed in three cases (due to tumor enlargement or need for the exact diagnosis). In the other cases, the treatment of non-comunicating hydrocephalus was the only treatment employed. The prognosis is of course dependent on the underlining pathology. In our series, except in the metastatic tumor case and the cavernoma, the other types of lesion consisted of low grade gliomas. These lesions represent a different type of brain stem tumor sharing a common good prognosis, with a benign behavior. We believe that tectal tumors must be managed case by case. When a patient presents with a benign lesions in the tectal region, treating the main symptom -hydrocephalus -should be the first attempt in management of these lesions.KEY WORDS: brain stem, tectal tumors, brain stem tumors, third ventriculostomy. Tumores da região tectalRESUMO -Tu m o res na região do teto mesencefálico são raros. Vários tipos de lesões como tumores, lesões v a s c u l a res, inflamatórias e infecciosas localizam-se nesta região. Nós revimos o tratamento adotado em sete pacientes com diferentes tipos de lesões tectais: cinco pacientes apresentando gliomas de baixo grau, um paciente com lesão metastática proveniente de câncer de pulmão e um com cavernoma. O tratamento cirúrgico com abordagem direta da lesão foi realizado em três casos (devido ao aumento do volume tumoral ou quando houve necessidade da confirmação diagnóstica). Nos demais casos o tratamento para a hidrocefalia não-comunicante foi o método empregado. O prognóstico dessas lesões é baseado no tipo de patologia em questão. Em nossa série, com exceção do caso de metástase e do paciente com cavern o m a , as demais lesões foram gliomas de baixo grau. Estas lesões re p resentam um subgrupo diferenciado de t u m o res de tronco encefálico, apresentando bom prognóstico e tendo comportamento benigno com sobrevida elevada. Acreditamos que tumores da região tectal devam ser avaliados caso a caso. Na hipótese diagnóstica de uma lesão benigna, o tratamento do principal complexo sindrômico -hidrocefalia não-comunicante -é provavelmente a melhor conduta a ser empregada. PALAVRAS-CHAVE: tronco cerebral, tumores da região tectal, ventriculostomia.

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An observation of the third ventricle under flexible fiberoptic ventriculoscope: Normal structure

Cited by 26 publications

References 6 publications

Neuroendoscopic approach to tectal tumors: a consecutive series

Neuroendoscopic approach to tectal tumors: a consecutive series

Endoscopic anatomy of the cerebellopontine angle: a study in cadaver brains

Tectal plate tumors

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