Tumors arising in the ventricular wall and its lining are considered primary ventricular tumors, and those originating in adjacent brain structures but with more than 2/3 exophytic growth within the ventricle, are considered secondary ventricular ones.
Common presentations and a potential complication of surgery: hydrocephalus, visual loss, endocrine dysfunction, and behavioral and cognitive deficits are both. Multimodal strategies, including stereotactic biopsy, radiosurgery, adjuvant radiotherapy, and chemotherapy are chosen to improve clinical outcomes.
Traditional and stereotactic microsurgical approaches: transfrontal, transcortical, and transcallosal routes to the ventricular system. “The best approach is the shortest distance to the lesion with a perpendicular field of view that requires minimal retraction of the brain and avoids trajectory through important structures”. The advent of endoscope-assisted microsurgery has greatly enhanced the technique of tumor removal. Furthermore endoscopic procedures, such as endoscopic third ventriculostomy, pellucidotomy, or aqueductoplasty, could be performed in the same session of tumor excision. There is no single surgical approach that can mitigate all anatomic obstacles occurring in ventricular lesions, but when tumor origin and extension are considered, a single approach can be implemented to attain complete surgical resection without recourse to combined approaches.
Common presentations and a potential complication of surgery: hydrocephalus, visual loss, endocrine dysfunction, and behavioral and cognitive deficits are both. Multimodal strategies, including stereotactic biopsy, radiosurgery, adjuvant radiotherapy, and chemotherapy are chosen to improve clinical outcomes.
Traditional and stereotactic microsurgical approaches: transfrontal, transcortical, and transcallosal routes to the ventricular system. “The best approach is the shortest distance to the lesion with a perpendicular field of view that requires minimal retraction of the brain and avoids trajectory through important structures”. The advent of endoscope-assisted microsurgery has greatly enhanced the technique of tumor removal. Furthermore endoscopic procedures, such as endoscopic third ventriculostomy, pellucidotomy, or aqueductoplasty, could be performed in the same session of tumor excision. There is no single surgical approach that can mitigate all anatomic obstacles occurring in ventricular lesions, but when tumor origin and extension are considered, a single approach can be implemented to attain complete surgical resection without recourse to combined approaches.
References
- Tew JM Jr, Lewis AI, Reichert KW. Management strategies and surgical techniques for deep-seated supratentorial arteriovenous malformations. Neurosurgery 36:1065-1072, 1995.
- D’Angelo VA, Galarza M, Catapano D, Monte V, Carosi I. Lateral ventricle tumors: surgical strategies according to tumor origin and development- a series of 72 cases. Neurosurgery 56[ONS Suppl 1]:ONS-36-ONS-45, 2005.
- Harris AE, Hadjipanayis CG, Lunsford LD, Lunsford AK, Kassam AB. Microsurgical removal of intraventricular lesions using endoscopic visualization andstereotactic guidance. Neurosurgery 56[ONS Suppl 1]:ONS-125-ONS-132, 2005.
- Charalampaki P, Filippi R, Welschehold S, Conrad J, Perneczky A. Tumors of the lateral and third ventricle: removal under endoscope-assisted keyhole conditions. Neurosurgery 57[ONS Suppl 3]:ONS-302-ONS-311, 2005.
