Stereotactic Endoscopic Interventions in Cystic Brain Lesions

Hellwig, Dieter; Bauer, B. L.; List-Hellwig, E.

doi:10.1007/978-3-7091-9419-5_13

Cited by 41 publications

(24 citation statements)

References 16 publications

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“…Colloid cysts were first described in an autopsic case in 1858 (51), and Dandy performed the first successful resection in 1921 (14). Since then, several therapeutic options have been proposed, ranging from shunting to freehand (21) and stereotactic (2,9,18,23,33,39,45) aspiration. To date, microsurgical resection with the use of either a transcallosal (3,4,13,37,49) or a transcortical- transventricular (3,13,20,28) approach has been accepted as the "gold standard" for the treatment of colloid cysts.…”

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confidence: 99%

Neuroendoscopic Treatment for Colloid Cysts of the Third Ventricle: The Experience of a Decade

Hellwig¹,

Bauer²,

Schulte³

et al. 2003

Neurosurgery

146

120

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confidence: 99%

Neuroendoscopic Treatment for Colloid Cysts of the Third Ventricle: The Experience of a Decade

Hellwig¹,

Bauer²,

Schulte³

et al. 2003

Neurosurgery

146

120

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“…35 Since that time, there have been several small case series reporting successful endoscopic resections of colloid cysts. [36][37][38][39][40][41][42][43][44][45][46][47][48][49] To date, there have been two reports comparing endoscopic to microsurgical resection. 24.28 These studies demonstrated shorter operative times and length of hospitalization in the endoscopic groups.…”

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confidence: 99%

Endoscopic Versus Microsurgical Resection of Third Ventricle Colloid Cysts

Grondin

Hader

MacRae

et al. 2007

Can. j. neurol. sci.

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Colloid cysts of the third ventricle represent about 0.5-2 percent of intracranial tumors.1,2 Although uncommon, they are an important clinical entity because of their ability to cause cerebrospinal fluid (CSF) obstruction and sudden death. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] In one population-based study, one third of patients with symptomatic colloid cysts presented with acute neurological deterioration, underscoring the need for their treatment. There has been some debate over the optimal management of colloid cysts over the past few decades. Management options include CSF diversion procedures (e.g. ventriculo-peritoneal ABSTRACT: Objective: Endoscopic resection of colloid cysts has been performed as an alternative to microsurgical resection and stereotactic aspiration since 1982. To date, there are limited published studies comparing these procedures. In this study, we present the largest series of endoscopic resections published to date and compare outcomes to a cohort of microsurgical resections performed at the same institution. Methods: A retrospective chart review was conducted for all patients in the Calgary Health Region undergoing resection of a colloid cyst between 1991 and 2004. Comparison was made between patients treated with endoscopic resection versus microsurgical resection. Results: Twenty-five endoscopic and nine microsurgical procedures were performed. Complete resection was achieved in 24 of 25 procedures in the Endoscopic group, compared with all 9 procedures in the Microsurgical group. Patients in the Endoscopic group had a reduced operative time (mean 104 minutes versus 217 minutes) and reduced length of stay (3.8 days versus 8.4 days) compared to the Microsurgical group. One patient in the Endoscopic group had a complication (hemiparesis/pulmonary embolus). By contrast, 3 patients in the Microsurgical group had complications (seizure, ventriculitis/bone flap infection, and transient memory deficit). There was one recurrence in each group which both occurred at 5 years follow-up. The mean length of follow-up is 38 months in the Endoscopic group and 33 months in the Microsurgical group. Conclusion: Endoscopic resection of colloid cysts can be performed with significantly lower risk of complication than microsurgical resection and with equivalent surgical success. Operative time and length of hospital stay are both significantly reduced with endoscopic resection. RÉSUMÉ: Résection endoscopique versus microchirurgicale des kystes colloïdes du troisième ventricule.Objectif : La résection endoscopique des kystes colloïdes comme alternative à la résection microchirurgicale et à l'aspiration stéréotaxique est réalisée depuis 1982. À ce jour, peu d'études comparant ces interventions ont été publiées. Dans cette étude, nous présentons la plus grande série de résections endoscopiques publiée à ce jour et nous comparons les résultats à ceux d'une cohorte de patients ayant subi une résection microchirurgicale dans la même institution. Méthodes : Nous avons procédé à une ré...

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“…2,6,8,9,14,15,[17][18][19][20]23 Although available neuroendoscopic equipment is rapidly advancing, the use of rigid instruments through narrow working channels is entirely coaxial, and most neurosurgical approaches leave little room for maneuvering, making tissue manipulation challenging. CSF cysts may therefore be considered as prime candidates for endoscopic fenestration because the operation does not involve extensive tissue resection, and cysts and ventricles offer sufficient CSF space to maneuver the endoscope.…”

Section: Fig 4 Postoperative T2-weighted Axial (A-d) and Contrast-ementioning

confidence: 99%

Endoscopic fenestration of intraventricular cerebrospinal fluid cysts: the contralateral approach

Hugelshofer

Koechlin

Marcus

et al. 2016

JNS

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OBJECT The endoscopic fenestration of intraventricular CSF cysts has evolved into a well-accepted treatment modality. However, definition of the optimal trajectory for endoscopic fenestration may be difficult. Distorted ventricular anatomy and poor visibility within the cyst due to its contents can make endoscopic fenestration challenging if approached from the ipsilateral side. In addition, transcortical approaches can theoretically cause injury to eloquent cortex, particularly in patients with dominant-sided lesions. The aim of this study was to examine the value of the contralateral transcortical transventricular approach in patients with dominant-sided ventricular cysts. METHODS During a 5-year period between 2007 and 2011, 31 patients with intraventricular CSF cysts underwent surgery by the senior author (R.R.). Fourteen of these patients had cysts located on the dominant side. An image-guided endoscopic cyst fenestration via the contralateral transcortical transventricular approach was performed in 11 patients. A retrospective chart review was performed in all these patients to extract data on clinical presentation, operative technique, and surgical outcome. RESULTS The most common presenting symptom was headache, followed by memory deficits and cognitive deterioration. In all cases CSF cysts were space occupying, with associated obstructive hydrocephalus in 8 patients. Image-guided endoscopic fenestration was successfully performed in all cases, with septum pellucidotomy necessary in 6 cases, and endoscopic third ventriculostomy in 1 case for additional aqueductal occlusion. Postoperative clinical outcome was excellent, with no associated permanent neurological or neuropsychological morbidity. No recurrent cysts were observed over a mean follow-up period of 2 years and 3 months. CONCLUSIONS The contralateral approach to ventricular cysts can achieve excellent surgical outcomes while minimizing approach-related trauma to the dominant hemisphere. Careful case selection is essential to ensure that the contralateral endoscopic trajectory is the best possible exposure for sufficient cyst fenestration and restoration of CSF circulation.

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Stereotactic Endoscopic Interventions in Cystic Brain Lesions

Cited by 41 publications

References 16 publications

Neuroendoscopic Treatment for Colloid Cysts of the Third Ventricle: The Experience of a Decade

Neuroendoscopic Treatment for Colloid Cysts of the Third Ventricle: The Experience of a Decade

Endoscopic Versus Microsurgical Resection of Third Ventricle Colloid Cysts

Endoscopic fenestration of intraventricular cerebrospinal fluid cysts: the contralateral approach

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