Microsurgical Fenestration of Thalamic Cyst Along With Third Ventriculostomy and Septal Fenestration via the Interhemispheric Transcallosal Approach: 3-Dimensional Operative Video

2017 ◽  
Vol 15 (2) ◽  
pp. 240-240
Author(s):  
Cem Dinc ◽  
Pinar Eser Ocak ◽  
Mustafa K Başkaya
Keyword(s):  
Third Ventriculostomy ◽  
Transcallosal Approach ◽  
3 Dimensional ◽  
Microsurgical Fenestration

scholarly journals Interhemispheric transcallosal transchoroidal approach to a pineal teratoma in a 15-year-old boy

2021 ◽  
Vol 5 (1) ◽  
pp. V5
Author(s):  
Giuseppe Cinalli ◽  
Maria Rosaria Scala ◽  
Alessandra Marini ◽  
Alessia Imperato ◽  
Giuseppe Mirone ◽  
...  
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Third Ventricle ◽  
Complete Removal ◽  
Endoscopic Biopsy ◽  
Immature Teratoma ◽  
Third Ventriculostomy ◽  
Surgical Removal ◽  
Transcallosal Approach ◽  
Neurovascular Structures ◽  
Very High

In this video, the authors present an interhemispheric transcallosal transchoroidal approach to a pineal mass in a 15-year-old boy. He received emergency endoscopic third ventriculostomy (ETV), then an endoscopic biopsy that revealed an immature teratoma. Surgical removal was selected. The mass was located very high in the posterior third ventricle, hidden behind the splenium of the corpus callosum and the vein of Galen, so an interhemispheric transcallosal approach followed by a complete dissection of the whole choroidal fissure was chosen and allowed complete removal of the tumor. Microsurgical dissection is presented, showing clearly in detail all the neurovascular structures encountered. The video can be found here: https://stream.cadmore.media/r10.3171/2021.4.FOCVID2126.

scholarly journals Endoscopic resection of a low-grade ependymoma of the pineal region

2021 ◽  
Vol 12 ◽  
pp. 279
Author(s):  
Claudio Schonauer ◽  
Gianpaolo Jannelli ◽  
Enrico Tessitore ◽  
Adrien Thomas May ◽  
Ramona Guatta ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Continuous Wave ◽  
Obstructive Hydrocephalus ◽  
External Ventricular Drain ◽  
Residual Tumor ◽  
Third Ventriculostomy ◽  
Low Grade ◽  
Endoscopic Removal ◽  
Transcallosal Approach ◽  
Frontal Horn

Background: Full endoscopic resection of solid brain tumors represents a challenge for neurosurgeons. This can be achieved with modern technology and advanced surgical tools. Case Description: A 23-years-old male was referred to our unit with raised intracranial pressure. Head computed tomography and magnetic resonance imaging (MRI) revealed obstructive hydrocephalus and a third ventricle lesion. Endoscopic third ventriculostomy and biopsy were performed, a left frontal external ventricular drain was left in place. A second-look surgery for endoscopic removal was planned. Decision to proceed with an endoscopic removal was supported by the following characteristics found during the first surgery: tumor exophytic, soft texture, scarce vascularity, and low-grade appearance. A rescue strategy for microscopic resection via transcallosal approach was decided. A straight trajectory to the tumor was planned with navigation. A further anterior left frontal burr-hole was performed, and the ventricular system was entered via the left frontal horn. Resection was carried out alternating laser for hemostasis and cutting, endoscopic ultrasonic aspirator, and endoscopic forceps for piecemeal resection. Laser hemostasis and cutting (1 Watt power at tip, continuous wave mode) were useful at the ventricular wall-tumor interface. Relevant landmarks guided the approach and the resection (foramen of Monro, mammillary bodies, aqueduct, pineal and suprapineal recess, and posterior commissure). The surgery was carried uneventfully. Histopathology confirmed a lowgrade ependymoma. Post-operative MRI showed residual tumor within the lower aqueduct. At 3 years follow-up, residual tumor is stable. Conclusion: In selected cases, endoscopic resection for third ventricular tumors is feasible and safe, and represents a valid alternative to microsurgical approaches.

Demonstration of Microsurgical Technique and Nuances for the Resection of a Midbrain Tectal Glioma Via the Transcollicular Approach: 3-Dimensional Operative Video

2020 ◽  
Author(s):  
Sima Sayyahmelli ◽  
Jian Ruan ◽  
Emel Avci ◽  
Mustafa K Başkaya
Keyword(s):  
Signal Intensity ◽  
Cystic Mass ◽  
World Health ◽  
High Signal ◽  
Third Ventriculostomy ◽  
Ataxic Gait ◽  
3 Dimensional ◽  
Postoperative Mri ◽  
Magnetic Resonance Imaging Mri ◽  
Health Organization

Abstract Tectal gliomas are a rare subset of intrinsic brainstem lesions. The microsurgical resection of these lesions remains a major challenge.1,2 Transcollicular approaches on one side, via the superior or inferior colliculi or both, are neurologically well tolerated without obvious or major auditory or oculomotor consequences. However, any postoperative acute visually triggered saccadic abnormalities caused by iatrogenic superior colliculus damage generally resolve during the postoperative period, as other oculomotor structures compensate for these functions in unilateral lesions.  In this surgical video, we present a 37-yr-old man with long-standing seizures, new onset headaches, progressive ataxic gait, and imbalance. Magnetic resonance imaging (MRI) showed a circumscribed nonenhancing dorsal midbrain cystic mass with compression on the aqueduct causing hydrocephalus. The lesion had a low signal intensity on T1-weighted images and a high signal intensity on T2-weighted images. The patient first underwent an endoscopic third ventriculostomy. Although his headaches greatly improved after the third ventriculostomy, he remained quite symptomatic in terms of gait imbalance and ataxia. The patient underwent a supracerebellar, infratentorial, transcollicular approach for resection of the tectal tumor. Simultaneously, motor and somatosensory evoked potentials were monitored.  Both the surgery and the postoperative course were uneventful, with postoperative MRI showing gross total resection of the mass, and histopathology indicating a WHO (World Health Organization) grade I pilocytic astrocytoma. The patient continued to do well without recurrence at 2-yr follow-up.  In this video, we demonstrate step-by-step microsurgical techniques for resecting these challenging tectal gliomas via the infratentorial-supracerebellar-transcollicular approach. The patient consented to the procedure and publication of his images.

Microsurgical Resection of Posterior Third Ventricular/Pineal Region Papillary Tumor Via Supracerebellar Infratentorial Approach: 3-Dimensional Operative Video

2018 ◽  
Vol 15 (6) ◽  
pp. E87-E87
Author(s):  
Sima Sayyahmelli ◽  
Ihsan Dogan ◽  
Mustafa K Başkaya
Keyword(s):  
Third Ventricle ◽  
Pineal Region ◽  
Direct Access ◽  
Third Ventriculostomy ◽  
Papillary Tumor ◽  
Pineal Region Tumor ◽  
3 Dimensional ◽  
History Of ◽  
Supracerebellar Infratentorial Approach ◽  
Microsurgical Resection

Abstract The posterior third ventricle and pineal region can harbor different pathologies. The supracerebellar infratentorial approach allows a direct access to the pineal region and posterior third ventricle and provides wide exposure of the arachnoid planes and deep venous system.  In this 3-dimensional video, we present a patient with posterior third ventricular/pineal region tumor who underwent microsurgical resection via supracerebellar infratentorial approach. The patient is a 28-year-old woman with history of hydrocephalus who underwent endoscopic third ventriculostomy and biopsy at an outside hospital. The histopatology of the tumor was papillary tumor of the pineal region. The patient was referred for further surgical resection due to enlargement of her tumor on follow-up radiological imaging. The surgery and the patient's postoperative course were uneventful and the patient remained unchanged in the postoperative period.  The important steps of the surgical approach and microsurgical resection are demonstrated in this 3-dimensional surgical video. The patient consented to publication of her images.

scholarly journals Transcallosal approach for third ventriculostomy and removal of midbrain cavernous malformation

2013 ◽  
Vol 34 (v1supplement) ◽  
pp. 1
Author(s):  
William T. Couldwell
Keyword(s):  
Brain Stem ◽  
Young Woman ◽  
Cavernous Malformation ◽  
Third Ventricle ◽  
Mass Effect ◽  
Third Ventriculostomy ◽  
Cavernous Malformations ◽  
Transcallosal Approach ◽  
The Third ◽  
Transforaminal Approach

Symptomatic brain stem cavernous malformations often present the dilemma of choosing an approach for their resection. Superior midline midbrain lesions are in a particularly challenging location, as they are less accessible via traditional lateral or posterior approaches. The author presents a case of a young woman who presented with a symptomatic cavernous malformation with surface presentation to the floor of the third ventricle. The lesion was causing sensory symptoms from local mass effect and hydrocephalus from occlusion of the Aqueduct of Sylvius. An approach was chosen to both perform a third ventriculostomy and remove the cavernous malformation. Through a right frontal craniotomy, a transcallosal–transforaminal approach was used to perform a third ventriculostomy. Through the same callosal opening, a subchoroidal approach was performed to provide access the cavernous malformation. The details of the procedure and nuances of technique are described in the narration.The video can be found here: http://youtu.be/zKKnehp7l2c.

Endoscope-Assisted Contralateral Perimedian Supracerebellar Suprapineal Approach to Third Ventricle Surface of the Thalamus: 3-Dimensional Operative Video

2020 ◽  
Vol 19 (3) ◽  
pp. E306-E307 ◽  
Author(s):  
Abdullah Keleş ◽  
Mehmet Volkan Harput ◽  
Uğur Türe
Keyword(s):  
Third Ventricle ◽  
Internal Capsule ◽  
Lateral Side ◽  
Surgical Removal ◽  
High Definition ◽  
Lateral Border ◽  
Transcallosal Approach ◽  
3 Dimensional ◽  
Bridging Veins ◽  
Thalamic Lesions

Abstract In managing thalamic gliomas, total surgical removal is the most effective way of increasing overall survival. However, the thalamus is a difficult target because of surrounding neurovascular structures. According to the lesion's size/location/growth pattern, relation to neighboring structures, and surgeon's experience, most thalamic lesions can be reached through one of the 4 free surfaces: lateral ventricle, velar, cisternal, and third ventricle surfaces of the thalamus (3VsT).1-3 Approaching the thalamic lesions through the lateral side disrupts the integrity of internal capsule and corona radiata; thus, we never prefer this approach. For the removal of the lesions on the 3VsT, a transcallosal approach can be considered, but with this approach, we cannot reach 3VsT without harming the velar surface.  In this 3-dimensional video, we demonstrate an endoscope-assisted contralateral perimedian supracerebellar suprapineal (CPeSS) approach to a glioma on the 3VsT. The patient, a 49-yr-old man, had progressive dizziness for a month. With the patient in a semisitting position, total resection was achieved via the endoscope-assisted CPeSS approach. This approach is entirely transcisternal-transventricular and is a natural route to the 3VsT. Although the route is longer than the ipsilateral approach, it requires no retraction and provides more direct and wider visualization. It allows complete visualization of the lateral border of the lesion. A perimedian approach also avoids the major tentorial bridging veins, which are mostly at the midline. High-definition neuroendoscope was a great adjunct that helped to visualize residual tumors at hidden corners.  We suggest this approach for thalamic lesions on the third ventricle surface of the thalamus.  The patient consented to the publication of his images and a written consent was obtained.

Three-Dimensional Reconstruction Using Stereo Pairs from Serial Thick Sections

1977 ◽  
Vol 35 ◽  
pp. 562-563
Author(s):  
Robert Glaeser ◽  
Thomas Bauer ◽  
David Grano
Keyword(s):  
Three Dimensional ◽  
Dimensional Structure ◽  
Serial Sections ◽  
Thin Sections ◽  
3 Dimensional ◽  
Transmission Electron ◽  
Freeze Dried ◽  
Dimensional Reconstruction ◽  
Stereo Imagery ◽  
Whole Mounts

In transmission electron microscopy, the 3-dimensional structure of an object is usually obtained in one of two ways. For objects which can be included in one specimen, as for example with elements included in freeze- dried whole mounts and examined with a high voltage microscope, stereo pairs can be obtained which exhibit the 3-D structure of the element. For objects which can not be included in one specimen, the 3-D shape is obtained by reconstruction from serial sections. However, without stereo imagery, only detail which remains constant within the thickness of the section can be used in the reconstruction; consequently, the choice is between a low resolution reconstruction using a few thick sections and a better resolution reconstruction using many thin sections, generally a tedious chore. This paper describes an approach to 3-D reconstruction which uses stereo images of serial thick sections to reconstruct an object including detail which changes within the depth of an individual thick section.

Structural preservation and absolute contrast of catalase crystal sections prepared with tannic acid

1983 ◽  
Vol 41 ◽  
pp. 448-449
Author(s):  
C.W. Akey ◽  
M. Szalay ◽  
S.J. Edelstein
Keyword(s):  
Tannic Acid ◽  
Beef Heart ◽  
X Rays ◽  
Screw Axis ◽  
General Applicability ◽  
Thin Sections ◽  
Beef Liver ◽  
3 Dimensional ◽  
Dimensional Reconstruction ◽  
Structural Preservation

Three methods of obtaining 20 Å resolution in sectioned protein crystals have recently been described. They include tannic acid fixation, low temperature embedding and grid sectioning. To be useful for 3-dimensional reconstruction thin sections must possess suitable resolution, structural fidelity and a known contrast. Tannic acid fixation appears to satisfy the above criteria based on studies of crystals of Pseudomonas cytochrome oxidase, orthorhombic beef liver catalase and beef heart F1-ATPase. In order to develop methods with general applicability, we have concentrated our efforts on a trigonal modification of catalase which routinely demonstrated a resolution of 40 Å. The catalase system is particularly useful since a comparison with the structure recently solved with x-rays will permit evaluation of the accuracy of 3-D reconstructions of sectioned crystals.Initially, we re-evaluated the packing of trigonal catalase crystals studied by Longley. Images of the (001) plane are of particular interest since they give a projection down the 31-screw axis in space group P3121. Images obtained by the method of Longley or by tannic acid fixation are negatively contrasted since control experiments with orthorhombic catalase plates yield negatively stained specimens with conditions used for the larger trigonal crystals.

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