Dataset Information

Endoscopic management of a cavernous malformation on the floor of third ventricle and aqueduct of Sylvius: Technical case report and review of the literature.

ABSTRACT: Intraventricular cavernous malformations are unusual intracranial vascular malformations; their deep anatomical location complicates their surgical management. Microsurgical approaches are the gold standard approaches for the resection of ventricular lesions, however, they imply considerable neurovascular risks.A 51-year-old patient presented with acute headache, diplopia, vertigo, blurred vision, and a depressed level of consciousness. A ventricular hemorrhage was treated with a ventriculostomy and the patient was discharged without hydrocephalus. After 11 days, he developed ataxia, diplopia, and a depressed level of consciousness. The patient was diagnosed with hydrocephalus secondary to the previous third ventricle hemorrhage. An endoscopic exploration using a 30° rigid ventricular endoscope was performed; after the third ventriculostomy, an intraventricular cavernous malformation located on the floor of the third ventricle and the aqueduct of Sylvius was resected.Three days after the surgery, magnetic resonance imaging demonstrated a gross total resection and adequate third ventriculostomy flow. One year after the surgery, the patient was asymptomatic. Neuroendoscopy has evolved towards minimally invasiveness, and in selected cases is an equally effective surgical approach to ventricular lesions. It provides minimal cerebral cortex disruption and vascular manipulation.

SUBMITTER: Ortega-Porcayo LA

PROVIDER: S-EPMC5629841 | biostudies-other | 2017

REPOSITORIES: biostudies-other

ACCESS DATA

Publications

Endoscopic management of a cavernous malformation on the floor of third ventricle and aqueduct of Sylvius: Technical case report and review of the literature.

Ortega-Porcayo Luis Alberto LA Perdomo-Pantoja Alexander A Palacios-Ortíz Isaac Jair IJ Cohen Salomon Cohen SC González-Mosqueda Juan Pablo JP Gómez-Amador Juan Luis JL

Surgical neurology international 20170926

<h4>Background</h4>Intraventricular cavernous malformations are unusual intracranial vascular malformations; their deep anatomical location complicates their surgical management. Microsurgical approaches are the gold standard approaches for the resection of ventricular lesions, however, they imply considerable neurovascular risks.<h4>Case description</h4>A 51-year-old patient presented with acute headache, diplopia, vertigo, blurred vision, and a depressed level of consciousness. A ventricular h ...[more]

PMID: 29026673

Similar Datasets

Project description:In this study, we aimed to introduce a technical note and to explore the efficacy of endoscopic surgery combined with diffusion tensor imaging (DTI) navigation for supratentorial deep cerebral cavernous malformations (CCM). A prospectively maintained database of CCM patients was reviewed to identify all CCM patients treated by endoscopic surgery. The sagittal T1-weighted anatomical magnetic resonance imaging (MRI) and DTI were acquired before surgery. Endoscopic surgery was planned and performed based on preoperative DTI images and intraoperative DTI navigation. All patients were followed up more than 6 months. Motor function deficit and modified Rankin scale (mRS) scores were documented on follow-up. A final mRS score of 0-2 was considered a good outcome, and a final mRS score >2 was considered a poor outcome. Second DTI and 3DT1 were performed at 3 months after surgery. We tracked the ipsilateral corticospinal tract (CST) on pre- and postoperative DTI images. The overall mean FA values and the number of fibers of tracked CST were compared on pre- and postoperative DTI images. Risk factors associated with motor deficits and poor outcomes were analyzed. Seven patients with deep CCM and treated by endoscopic surgery were enrolled in this study. The mean value of preoperative mRS was 1.5 ± 0.98, but that score recovered to 0.86 ± 1.22 3 months later. The mRS scores were improved significantly according to statistical analysis (p = 0.012). According to the Spearman non-parametric test, only the fiber number of ipsilateral CST on postoperative DTI was significantly associated with muscle strength 6 months after surgery (p = 0.032). Compared with preoperative CST characteristics on DTI, the change of FA value (p = 0.289) and fiber number (p = 0.289) of ipsilateral CST on postoperative DTI was not significant It meant that the CST was protected during endoscopic surgery. Endoscopic surgery based on DTI navigation might be an effective method to protect fiber tracts in supratentorial deep CCM patients and improve long-term outcomes. However, more studies and cases are needed to confirm our findings.

Dataset Information

Endoscopic management of a cavernous malformation on the floor of third ventricle and aqueduct of Sylvius: Technical case report and review of the literature.

Publications

Endoscopic management of a cavernous malformation on the floor of third ventricle and aqueduct of Sylvius: Technical case report and review of the literature.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets