Tag: Transventricular approach

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Surgical management of intraventricular central neurocytoma: 92 cases

Acta Neurochir (2012) 154:1951–1960 

Objective To analyse the clinical characteristics of intraventricular central neurocytomas and gain a better understanding of the surgical management and treatment strategies.

Methods A total of 92 cases of intraventricular central neurocytomas with initial treatment using surgical resection were studied retrospectively.

Results Among 48 male and 44 female patients, 65 underwent gross total resection and 27 underwent subtotal resection. Transcortical or transcallosal approaches were performed, and there was no significant difference between the two approaches in terms of effects and complications. Tumours with calcification or adhesion had a significant lower gross total resection rate. Three patients died after surgery. During follow-up, 55 patients underwent postoperative radiotherapy and four patients had a recurrence of the tumour.

Conclusion Central neurocytomas mostly occur in the lateral ventricle system near the foramen of Monro. Therefore, total resection is the best treatment. Two surgical approaches are possible as treatment. Calcifications or adhesions affect the gross total resection of the tumour. Radiation therapy or radiosurgery therapy can be chosen as a salvage treatment in case of recurrence.

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Long-term Results of the Neuroendoscopic Management of Colloid Cysts of the Third Ventricle: A Series of 90 Cases

Neurosurgery 68:179–187, 2011 DOI: 10.1227/NEU.0b013e3181ffae71

The endoscopic removal of third ventricular colloid cysts has been developed as an alternative to microsurgical transcortical-transventricular and transcallosal approaches.

OBJECTIVE: To examine the value of endoscopic technique by reviewing the large number of endoscopically treated patients with long-term follow-up in 2 neurosurgical centers.

METHODS: A retrospective chart review was conducted for all patients admitted for resection of a third ventricular colloid cyst to the Radboud University Nijmegen Medical Centre (Nijmegen, the Netherlands) and the Hoˆ pital Henri Mondor (Paris, France) between 1994 and 2007. Both clinical and radiological symptoms and operative results were evaluated.

RESULTS: Postdischarge clinical follow-up was available for 85 patients over a mean period of 4 years 3 months. Permanent morbidity occurred in 1 patient (persisting preoperative memory deficit). Follow-up imaging of 80 evaluable patients showed that total or nearly total cyst removal was possible in 46 individuals (57.5%). Residual cyst was present in 34 patients (42.5%), and 6 required repeated endoscopic surgery for symptomatic regrowth. Recurrent cysts were mainly seen within the first 2 years after surgery.

CONCLUSION: It is debatable whether the higher numbers of recurrent or residual cysts can be justified by the slightly lower complication rates achieved with endoscopic removal. However, results have been improving over the years. Moreover, the modifications observed on control magnetic resonance images justify the need for regular control imaging for at least the first 2 years postoperatively.

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