Endoscopic Anatomy of Lateral and Third Ventricles

Sahana, Debabrata; Rathore, Lavlesh; Kumar, Sanjeev; Sahu, Rajiv

doi:10.4103/0028-3886.310075

Cited by 9 publications

(7 citation statements)

References 7 publications

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“…The use of endoscopes for endoscopic third ventriculostomy or biopsy of lesions is well described. 3 Purely endoscopic approach for choroid plexus papilloma has been sparingly described in the literature. 1,[4][5][6] The choice of its use depends a lot upon the comfort of the neurosurgeon and familiarity with the endoscopic anatomy.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic Excision of Third Ventricle Choroid Plexus Papilloma

Rathore

Sahana

Kumar

et al. 2023

Indian Journal of Neurosurgery

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Introduction Choroid plexus papilloma is a rare intraventricular tumor in children. Its management poses a challenge. Here we describe such a case of third ventricular choroid plexus papilloma and its endoscopic excision through a single burr hole. Case Description A 1-year-old child presented with headache, vomiting, and a large head with sunset sign and tense fontanel. Computed tomography (CT) and magnetic resonance imaging brain plain and contrast revealed dilated ventricles with a frondlike mass in the third ventricle with intense contrast enhancement, suggestive of choroid plexus papilloma of the third ventricle. The lesion was excised completely using an endoscope placed through a single burr hole at the right Kocher's point. Postoperative recovery was uneventful. The child was relieved of his symptoms. CT scan revealed complete removal of the lesion. Histopathology confirmed the diagnosis of choroid plexus papilloma. Results and Conclusion We document our surgical experience and present an edited video of the surgery. The key steps and nuances are described in the audio timeline. The authors acknowledge the feasibility of performing this complex surgery via a minimally invasive method, which has not been accepted routinely for this pathology.

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Section: Discussionmentioning

confidence: 99%

“…1,[4][5][6] The choice of its use depends a lot upon the comfort of the neurosurgeon and familiarity with the endoscopic anatomy. 3 Ventriculomegaly is a necessity. The excellent vision provided by the endoscope into the corners, which is often not possible with microscopes, makes appreciation of the pedicle of the tumor possible.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Excision of Third Ventricle Choroid Plexus Papilloma

Rathore

Sahana

Kumar

et al. 2023

Indian Journal of Neurosurgery

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“…Endoscopic ventriculocisternostomy is a physiological procedure like endoscopic third ventriculostomy. 3 It avoids shunt-related complications.…”

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Endoscopic Ventriculocisternostomy for Treatment of Trapped Temporal Horn: 2-Dimensional Operative Video

Sahana

Rathore

Kumar

et al. 2023

Operative Neurosurgery

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Trapped temporal horn is a rare disorder with an isolated dilatation of the temporal horn secondary to obstruction of cerebrospinal fluid (CSF) flow at the atrium. The etiology may be both congenital and acquired. 1 These patients remain asymptomatic for a long time, but continuous ventricular enlargement produces raised intracranial pressure symptoms, visual field defects, hemiparesis, memory disturbances, and altered mentation. 2 Symptomatic patients require CSF diversion. Endoscopic ventriculocisternostomy is a physiological procedure like endoscopic third ventriculostomy. 3 It avoids shunt-related complications. We managed a case of a 7-year-old boy with a congenital trapped temporal horn. The pathology, radiological features, and management options are discussed. The patient's relative consented to the endoscopic ventriculocisternostomy. A fenestration was made in the tenia fimbria to communicate the temporal horn with the ambient cistern. 4 The visual impression of the ventricular anatomy appears different from the microscopic anatomic description in cadavers. 5 A thorough understanding of endoscopic ventricular anatomy is essential to perform such endoscopic procedures safely. The literature lacks an elaboration of ventricular anatomy from an endoscopic perspective. [6][7][8] We have described the correlation between microscopic and endoscopic anatomy and the surgical procedure. After surgery, the patient improved clinically, and at 4-month follow-up, he was doing well with stable ventricle size. The CSF flow across the fenestration can be visualized by cine phasecontrast MRI, which was also seen in the present case. 9 Images throughout the video from Rhoton, 5 modified with permission from the Congress of Neurological Surgeons.

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“…It often requires neuronavigation assistance. 1,2 Microscopic subfrontal lamina terminalis fenestration has been proven effective in managing SVS. 4,5 We have recently introduced a similar endoscopic extra-axial alternative to conventional ETV for managing hydrocephalus.…”

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confidence: 99%

“…1 This symptomatic ventricular collapse may present with recurrent headaches, neuropsychiatric disturbances, reduced cognition, visual disturbances, and rarely sudden death due to hypothalamic dysfunction. 1,2 The treatment choice varies from shunt ligation/exteriorization, increasing the opening pressure of the shunt valve, adding an antisiphon device, and subtemporal decompression. 1,2 ETV, a most physiological treatment, is effective in approximately 83% of cases.…”

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confidence: 99%