Advanced needle neuroendoscopy technique in the treatment of pineal cyst

Abstract

Modern neurosurgical equipment and techniques, neuroendoscopy in particular, allow performing complex operations even in the deep and narrow anatomical structures of the brain without injuring vessels or soft tissue and consequently lowers risk of postoperative complications. The surgical treatment includes classical open microsurgical and mini-invasive neuroendoscopic cystoventriculostomy or cystocysternostomy depending on the cyst localization. In this work, we present a case of surgical treatment of a pineal cyst of a 1 year 6 months old boy with a semi-rigid neuroendoscope under neuronavigation and ultrasound guidance and provide the advantages of this technique. The good clinical and radiological improvement observed in our patient is the result of the use of triple intraoperative monitoring including a semi-rigid needle neuroendoscope, neuronavigation, ultrasound and, thus, the neurosurgeon has the entire picture of the delicate structures that allows carry our surgical intervention (endoscopic cyst fenestration) with the greatest precision and safety.