Anterior endoscopic transcortical approach to a pineal region cavernous hemangioma.

Jiuhong Li,Lunxin Liu,Liangxue Zhou,Jiaojiang He

doi:10.3171/2021.4.focvid215

Jiuhong Li, Lunxin Liu + Show 2 more

Open Access

https://doi.org/10.3171/2021.4.focvid215

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Abstract

A 57-year-old female presented with headache and dizziness for 3 months. Preoperative MRI revealed a lesion located at the pineal region and back side of the third ventricle, accompanied by hydrocephalus. The infratentorial supracerebellar approach may cause visuomotor, acousticomotor, and hearing disturbances. With the patient in a supine position, the authors used a frontal linear incision that was 3 cm anterior to the coronal suture and 2 cm away from the midline and an anterior endoscopic transcortical approach, which could achieve endoscopic third ventriculostomy, alleviating and preventing hydrocephalus due to postoperative adhesion and resection of the lesion at the same time. The pathological diagnosis was cavernous hemangioma.The video can be found here: https://stream.cadmore.media/r10.3171/2021.4.FOCVID215.

Highlights

Anterior endoscopic transcortical approach to a pineal region cavernous hemangioma
MRI showed the lesion located at the pineal region and back of third ventricle, which leads to obstructive hydrocephalus
For the lesion located at the anterior side of pineal region, there are four approaches to access the lesion backward

Summary

Introduction

Anterior endoscopic transcortical approach to a pineal region cavernous hemangioma. MRI showed the lesion located at the pineal region and back of third ventricle, which leads to obstructive hydrocephalus. The diagnosis was pineal region lesion (cavernous hemangioma most likely), accompanied by obstructive hydrocephalus. For the lesion located at the anterior side of pineal region, there are four approaches to access the lesion backward.

Results

Conclusion