Endoscopic third ventriculostomy for hydrocephalus in brainstem glioma: a case series

Kobayashi, Noboru; Ogiwara, Hideki

doi:10.1007/s00381-016-3065-7

Cited by 12 publications

(5 citation statements)

References 18 publications

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“…ETV is regarded as the treatment of choice to relieve OH. When OH is caused by an aqueductal tumor, both tumor removal and ETV are possible by endoscope [13,14]. The success rate of ETV is more than 70%, which is high enough for clinical application [1][2][3][4][5].…”

Section: Discussionmentioning

confidence: 99%

Impending Blindness by Obstructive Hydrocephalus Intractable to Endoscopic Third Ventriculostomy: Case Report

Shirasaka

Yasuda

Takeuchi

et al. 2021

SN Compr. Clin. Med.

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Endoscopic third ventriculostomy (ETV) has been accepted for obstructive hydrocephalus (OH). We herein present a case of OH and optic nerve sheath edema (ONSE). Although ETV was successful, ONSE worsened. Discussion is focused on the relationship among intracranial hypertension (IH), ETV, and ONSE. The patient was a 19-year-old woman with complaints of headache and emesis. Papilledema was prominent. Radiological examination showed OH as an aqueductal tumor. Endoscopic tumorectomy and ETV were accomplished. Although headache and emesis disappeared, papilledema persisted. On the 4th day, the patient lost light perception. On magnetic resonance imaging, the third ventricular stroma and aqueduct were patent. Nevertheless, ONSE was prominent. After lumbar drainage, her vision was restored. Finally, ventriculoperitoneal shunting was performed, following which ONSE disappeared. IH is not always accompanied by ONSE. However, once it occurs, it may act separately from IH, and ETV may even exacerbate ONSE due to alteration of cerebrospinal fluid (CSF) flow into the chiasmatic cistern. In the optic nerve sheath, CSF pressure is not easily transmitted across different areas; this should explain the dissociation between ONSE and other symptoms of IH. Furthermore, we suggest that ONSE and acute optic dysfunction should be considered an independent crisis as “hydronervus opticus.”

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Section: Discussionmentioning

confidence: 99%

Impending Blindness by Obstructive Hydrocephalus Intractable to Endoscopic Third Ventriculostomy: Case Report

Shirasaka

Yasuda

Takeuchi

et al. 2021

SN Compr. Clin. Med.

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“…In children, certain tumor locations, such as the tectum or the dorsal brainstem, are pathognomonic for pLGG, specifically pilocytic astrocytoma (PA), and it is disputed whether these tumors even require a biopsy to confirm the diagnosis, since surgery around the brainstem has a rate of postoperative morbidity of up to 30% [9,19]. Therefore, if hydrocephalus is apparent, endoscopic biopsy is obtained simultaneously to an endoscopic third ventriculostomy (ETV), which is indicated in order to treat the aqueduct stenosis caused by the tumor [20][21][22]. A classic location for aLGG is the insular region, which presents specific challenges (Figure 1).…”

Section: Histology and Anatomical Locationmentioning

confidence: 99%

Pediatric and Adult Low-Grade Gliomas: Where Do the Differences Lie?

2021

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Two thirds of pediatric gliomas are classified as low-grade (LGG), while in adults only around 20% of gliomas are low-grade. However, these tumors do not only differ in their incidence but also in their location, behavior and, subsequently, treatment. Pediatric LGG constitute 65% of pilocytic astrocytomas, while in adults the most commonly found histology is diffuse low-grade glioma (WHO II), which mostly occurs in eloquent regions of the brain, while its pediatric counterpart is frequently found in the infratentorial compartment. The different tumor locations require different skillsets from neurosurgeons. In adult LGG, a common practice is awake surgery, which is rarely performed on children. On the other hand, pediatric neurosurgeons are more commonly confronted with infratentorial tumors causing hydrocephalus, which more often require endoscopic or shunt procedures to restore the cerebrospinal fluid flow. In adult and pediatric LGG surgery, gross total excision is the primary treatment strategy. Only tumor recurrences or progression warrant adjuvant therapy with either chemo- or radiotherapy. In pediatric LGG, MEK inhibitors have shown promising initial results in treating recurrent LGG and several ongoing trials are investigating their role and safety. Moreover, predisposition syndromes, such as neurofibromatosis or tuberous sclerosis complex, can increase the risk of developing LGG in children, while in adults, usually no tumor growth in these syndromes is observed. In this review, we discuss and compare the differences between pediatric and adult LGG, emphasizing that pediatric LGG should not be approached and managed in the same way as adult LCG.

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“…[ 6 ] Primitively, ETV was used to treat hydrocephalus caused only by aqueductal stenosis (AS), both congenital and acquired. However, it is currently indicated in hydrocephalus caused by congenital conditions such as Dandy–Walker malformation, syringomyelia, meningomyelocele, and craniosynostosis, as well as secondary to shunt malfunction, cerebellar infarcts, slit ventricle syndrome, posterior fossa lesions,[ 7 8 ] pineal lesions,[ 9 ] and brainstem lesions[ 10 ] causing obstructive hydrocephalus.…”

Section: Endoscopic Third Ventriculostomymentioning

confidence: 99%

A review of common endoscopic intracranial approaches

et al. 2020

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With the evolution of surgical techniques, endoscopy has emerged as a suitable alternative to many instances of more invasive methods. In this review article, we aim to discuss the endoscopic advancements, procedural details, indications, and outcomes of the most commonly practiced neuroendoscopic procedures. We have also summarized the uses, techniques, and challenges of neuroendoscopy in select neurosurgical pathologies.

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Endoscopic third ventriculostomy for hydrocephalus in brainstem glioma: a case series

Abstract: The ETV is considered to be an effective and safe procedure for the treatment of hydrocephalus in brainstem gliomas. Determining the ventriculostomy site according to the preoperative MRI in each case is considered to be important for the safe procedure.

Cited by 12 publications

References 18 publications

Impending Blindness by Obstructive Hydrocephalus Intractable to Endoscopic Third Ventriculostomy: Case Report

Impending Blindness by Obstructive Hydrocephalus Intractable to Endoscopic Third Ventriculostomy: Case Report

Pediatric and Adult Low-Grade Gliomas: Where Do the Differences Lie?

A review of common endoscopic intracranial approaches

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