Endoscopic Fenestration of Cavum Septum Pellucidum Cysts to the Third Ventricle: Technical Note

2020 ◽  
Vol 19 (4) ◽  
pp. E434-E439
Author(s):  
Alexandre Simonin ◽  
Omar Bangash ◽  
Arjun S Chandran ◽  
Erik Uvelius ◽  
Christopher Lind
Keyword(s):  
Surgical Procedure ◽  
Clinical Presentation ◽  
Third Ventricle ◽  
Technical Note ◽  
Septum Pellucidum ◽  
Imaging Studies ◽  
Foramen Of Monro ◽  
Cavum Septum Pellucidum ◽  
The Third ◽  
Endoscopic Fenestration

Abstract BACKGROUND AND IMPORTANCE Cavum septum pellucidum (CSP) and cavum vergae (CV) cysts are common incidental findings on imaging studies. However, they may rarely present with symptoms related to the obstruction of the foramen of Monro by the cyst leaflets. There is no consensus regarding the management of symptomatic CSP and CV cysts. We present an original transcavum interforniceal endoscopic fenestration technique. The step-by-step surgical procedure and two illustrative cases are presented. CLINICAL PRESENTATION A 31-yr-old male and a 24-yr-old woman presented with symptomatic CSP and CV cysts. For both patients, neuronavigation was used to plan the procedure. An endoscope was introduced into the cyst through a right frontal burr-hole. After an examination of the endoscopic anatomy, a communication between the cyst and the third ventricle was performed using an endoscopic forceps. In both cases, directly after the fenestration, cerebrospinal fluid (CSF) passed through the communication, and the collapse of the cyst was appreciated. Symptoms were relieved in both patients, and neuropsychological assessment improved. Postoperative imaging showed a reduction in the cyst bulge, and patent foramen of Monro. CONCLUSION Endoscopic fenestration of CSP and CV cysts to the third ventricle through an interforniceal navigated approach is a feasible and efficient surgical procedure. Theoretical advantages include a single tract through noneloquent brain, a perpendicular trajectory to the membrane for fenestration, and a large CSF space beyond the fenestration point.

scholarly journals Frame-Based Stereotactic-Guided Excision of Colloid Cyst of Cavum Septum Pellucidum through Transcallosal Approach—A Technical Note

2017 ◽  
Vol 07 (03) ◽  
pp. 235-238
Author(s):  
J. Parthiban ◽  
S. Shanthanam ◽  
R. Manivasagam
Keyword(s):  
Corpus Callosum ◽  
Third Ventricle ◽  
Colloid Cyst ◽  
Technical Note ◽  
Septum Pellucidum ◽  
Cavum Septum Pellucidum ◽  
Intracranial Lesion ◽  
Transcallosal Approach ◽  
The Third ◽  
Stereotactic Guidance

AbstractColloid cyst is a rare benign intracranial lesion. Due to its embryologic origin and development, it is commonly located within the third ventricle, though it also presents at various locations. Its location within cavum septum pellucidum is rarely reported. Operative approaches to such lesion can be challenging and misleading due to intraoperative variations. However, surgical resection in such locations are simplified and perfected with stereotactic guidance. A case of colloid cyst within the cavum septum pellucidum and the importance of stereotactic guidance in precisely reaching the lesion, thus minimizing the dissection of corpus callosum, are discussed.

scholarly journals Anterior Transcallosal Interforniceal Approach to the Third Ventricle via a Cavum Septum Pellucidum and Cavum Vergae

2021 ◽  
pp. 101338
Author(s):  
Keisuke Ohnaka ◽  
Toshiki Watanabe ◽  
Satoshi Kaneko ◽  
Takamaro Takei ◽  
Tomoaki Okada ◽  
...  
Keyword(s):  
Third Ventricle ◽  
Septum Pellucidum ◽  
Cavum Septum Pellucidum ◽  
The Third ◽  
Cavum Vergae

scholarly journals Cavernoma of the foramen of Monro

2006 ◽  
Vol 21 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Pierluigi Longatti ◽  
Alessandro Fiorindi ◽  
Alessandro Perin ◽  
Vittorio Baratto ◽  
Andrea Martinuzzi
Keyword(s):  
Clinical Presentation ◽  
Third Ventricle ◽  
Cavernous Angioma ◽  
Colloid Cyst ◽  
Initial Diagnosis ◽  
Foramen Of Monro ◽  
Microsurgical Technique ◽  
The Third ◽  
Direct View

✓The authors report on a patient who presented with an intraventricular mass located at the level of the foramen of Monro. The clinical presentation and neuroimaging appearance of the mass led to an initial diagnosis of colloid cyst. A neuroendoscopic approach offered a direct view of the ventricular lesion, which was found to be a cavernous angioma partially occluding the foramen of Monro. The lesion was then removed using microsurgery. In this report the authors highlight possible pitfalls in the diagnosis of some lesions of the third ventricle, and the possible advantages of using a combined endoscopic and microsurgical technique when approaching such lesions.

scholarly journals Excision of Colloid Cyst through Interhemispheric, Transcallosal, Transcavum, Interfornicial Approach

2021 ◽  
Author(s):  
Santosh Kumar ◽  
Nishanth Sadashiva
Keyword(s):  
Third Ventricle ◽  
Colloid Cyst ◽  
Septum Pellucidum ◽  
Cavum Septum Pellucidum ◽  
Transcallosal Approach ◽  
The Third ◽  
Usual Location ◽  
Colloid Cysts

AbstractColloid cysts (CC) occur predominantly in the midline with majority involving roof of the third ventricle. In cases of cavum septum pellucidum (CSP), the surgeon can lose orientation when normal intraventricular structures are not encountered during surgery. We report a patient with CSP, who underwent right frontal parasagittal craniotomy, interhemispheric, transcallosal approach to reach the lesion. Lesion may not be seen in its usual location of foramen of Monroe, and entering the cavum may be confusing because no intraventricular landmarks will be seen. Excision of the cyst through the cavum usually requires interfornicial approach, and this structure must be separated gently to avoid injury.

scholarly journals Endoscopic fenestration at the splenial-habenular junctional area for symptomatic cavum and tumor at the foramen of Monro: case reports and anatomical review

2015 ◽  
Vol 122 (3) ◽  
pp. 504-510 ◽  
Author(s):  
Zamzuri Idris ◽  
Jason Raj Johnson ◽  
Jafri Malin Abdullah
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Case Reports ◽  
Obstructive Hydrocephalus ◽  
Third Ventricle ◽  
Third Ventriculostomy ◽  
Csf Flow ◽  
Foramen Of Monro ◽  
The Third ◽  
Quadrigeminal Cistern ◽  
Endoscopic Fenestration

The splenial-habenular junctional area is an alternative site for neuroendoscopic fenestration to divert CSF flow into the quadrigeminal cistern in cases in which endoscopic third ventriculostomy is not amenable. In some patients with obstructive hydrocephalus, the splenium of the corpus callosum can be elevated from the habenular complex. This exposes the membranous connection between the splenium and habenula, which can be fenestrated to divert the CSF flow into the quadrigeminal cistern. This technique can be performed in patients in whom the foramen of Monro or the third ventricle is blocked by a lesion. Here, the authors present 3 complex cases that were managed by neuronavigation-guided transventricular transcavum endoscopic fenestration of the splenial-habenular junctional area. These cases may increase the knowledge and understanding of the anatomy of this region.

Purely Endoscopic Resection of Colloid Cysts

2008 ◽  
Vol 62 (suppl_1) ◽  
pp. ONS51-ONS56 ◽  
Author(s):  
Jeremy D.W. Greenlee ◽  
Charles Teo ◽  
Ali Ghahreman ◽  
Bernard Kwok
Keyword(s):  
Endoscopic Resection ◽  
Third Ventricle ◽  
Colloid Cyst ◽  
Foramen Of Monro ◽  
The Third ◽  
Colloid Cysts ◽  
Study Support

Abstract Objective: To further assess the safety and long-term efficacy of endoscopic resection of colloid cysts of the third ventricle. Methods: A retrospective review of a series of 35 consecutive patients (18 male, 17 female) with colloid cysts treated by endoscopic surgery was undertaken. Results: The mean patient age was 32.4 years (range, 11–54 yr). Headache was the most common presenting symptom (22 patients). The average tumor size was 18 mm (range, 3–50 mm). The endoscopic technique could not be completed in six patients, necessitating conversion to an open craniotomy and a transcortical approach to the colloid cyst. All patients had histologically confirmed colloid cysts of the third ventricle, and complete resection of the lesion was confirmed macroscopically and radiologically in all patients. There were no deaths. Two patients developed aseptic meningitis without any permanent sequelae. One patient developed unilateral hydrocephalus attributable to obstruction of the foramen of Monro, which was treated with endoscopic septum pellucidotomy. The median follow-up period was 88 months (range, 10–132 mo). There was one asymptomatic radiological recurrence. No seizures occurred after surgery. Conclusion: The results of this study support the role of endoscopic resection in the treatment of patients with colloid cysts as a safe and effective modality. In some cases, conversion to an open procedure may be required. Additional follow-up will be required to continue to address the duration of lesion-free survival.

Spontaneous Resolution of Cavum Veli Interpositi

2008 ◽  
Vol 21 (6) ◽  
pp. 805-809
Author(s):  
S. Vattoth ◽  
Y.S. Kim ◽  
E. Norman ◽  
G.H. Roberson
Keyword(s):  
Case Reports ◽  
Third Ventricle ◽  
Septum Pellucidum ◽  
Spontaneous Resolution ◽  
Cerebral Veins ◽  
Cavum Septum Pellucidum ◽  
Internal Cerebral Veins ◽  
Cavum Veli Interpositi ◽  
Quadrigeminal Plate ◽  
Forward Extension

Cavum veli interpositi is an open CSF space in the roof of the third ventricle that surrounds the internal cerebral veins, and is a forward extension of the quadrigeminal plate cistern. To the best of our knowledge, spontaneous resolution of a cavum veli interpositi has not been reported in the literature to date. Interestingly, case reports of spontaneous resolution of cystic cavum septum pellucidum in three patients and eighteen arachnoid cyst cases has been described in the literature. We describe the spontaneous resolution of a cavum veli interpositi or cyst in cavum veli interpositi in a 35-year-old man and review the literature of spontaneous resolution of cavum septum pellucidum and arachnoid cysts.

Endoscopic fenestration of the third ventricle in the reverse direction

2007 ◽  
Vol 24 (4) ◽  
pp. 507-508 ◽  
Author(s):  
Kenichi Nishiyama ◽  
Hiroshi Mori ◽  
Junichi Yoshimura ◽  
Yukihiko Fujii
Keyword(s):  
Third Ventricle ◽  
Reverse Direction ◽  
The Third ◽  
Endoscopic Fenestration

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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