A new surgical approach to the third ventricle with interruption of the striothalamic vein

Abstract

In the removal of tumours that develop within the third ventricle, most approaches are not entirely satisfactory. Therefore, a new approach has been devised: transfrontal exposure of the anterior portion of the frontal horn; coagulation and section of the striothalamic vein in order to open up the roof of the third ventricle; use of a blunt spatula introduced in the foramen of Monro and pushed backwards under the choroïd plexus. This approach has been used in ten cases. Postoperative mortality has been nil; the surgical approach has not apparently been responsible for any sequelae. It is simple and gives a good view of the third ventricle.

Approach Problems in Anterior Third Ventricle Tumors: Review of 33 Cases

“…Although anatomic tumor site determines surgical approach, we see from papers presented today and from pub1icated material that neurosurgeons use differentapproaches in treating tumors of same anatomic site with equal success (Long and Chou 1973;King 1979;Shucart and Stein 1978;Hirsch et al 1979). That confirms the opinion that during tumor exposure and removal extremely' precise microsurgical technique with preservation of vascular irrigation and drainage is of essential importance.…”

“…In surgical treatment of anterior third ventricle tumors different approaches are used regarding the pathologic process and site (Stein 1977;Hirsch et al 1979;Patterson and Danylevich 1980;Viale and Turtas 1980;Rhoton et al 1981;Suzuki et al 1984). Although anatomic tumor site determines surgical approach, we see from papers presented today and from pub1icated material that neurosurgeons use differentapproaches in treating tumors of same anatomic site with equal success (Long and Chou 1973;King 1979;Shucart and Stein 1978;Hirsch et al 1979).…”

Interhemispheric transcallosal subchoroidal fornix-sparing craniotomy for total resection of colloid cysts of the third ventricle

“…[1][2][3][4][5][6][7][8][9][10] Analysis of the literature describing cranial endoscopic removal of colloid cysts of the third ventricle suggests a 20-59% radiographic remnant cyst rate due to the fact that the cyst wall attachment is to the roof of the third ventricle caudal to the foramen of Monro. 1,3,4,[6][7][8][9] The symptomatic recurrence rate for these remnant cysts appears to be in the 5-10% range. In 1985, we developed a modification of the interhemispheric, transcallosal approach to include a subchoroidal fornix-sparing opening into the roof of the third ventricle for complete resection of colloid cysts of the third ventricle.…”

Technical strategies for the transcallosal transforaminal approach to third ventricle tumors: expanding the operative corridor

“…7 Hirsch et al sacrificed the thalamostriate vein as a means of increasing the aperture of the foramen posteriorly. 2 Transection of the anterior septal vein, which allows medial mobilization of the fornix and lateral retraction of the thalamostriate vein, did not result in any venous complications in our series. We could not find any report in the literature that described a complication with this maneuver.…”

“…Alternatively, the choroidal fissure lateral to the choroid plexus can be opened (the taenia choroidea) in what is called the "subchoroidal" approach. 1,2 The interforniceal approach has been described for pathology located in the hypothalamic region of the third ventricle, particularly hamartomas. 10 This approach is easier if the patient has an existing cavum septum pellucidum so as to minimize manipulation of both forniceal columns.…”