Surgical approach to thalamic tumors

Özek, M. Memet; Türe, Uğur

doi:10.1007/s00381-002-0608-x

Cited by 58 publications

(45 citation statements)

References 30 publications

(66 reference statements)

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“…Tables 1 and 2 list the structures and surfaces of the pulvinar accessed by each approach. Potential complications related to each approach are listed in Table 3. 14, 27,29,35 The superior parietal lobule, interhemispheric transprecuneus, and lateral transcallosal approaches open directly into the ventricle but at slightly different angles, and all 3 provide access through the choroidal fissure or posterior to the fornix to the adjacent cisternal part. The superior parietal lobule approach provides the most anterior access with the transprecuneus approach entering the ventricle slightly posterior to the superior parietal lobule approach.…”

Section: Discussionmentioning

confidence: 99%

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Microsurgical and endoscopic approaches to the pulvinar

Akiyama

Matsushima

Güngör

et al. 2017

Journal of Neurosurgery

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OBJECTIVEApproaches to the pulvinar remain challenging because of the depth of the target, surrounding critical neural structures, and complicated arterial and venous relationships. The purpose of this study was to compare the surgical approaches to different parts of the pulvinar and to examine the efficacy of the endoscope as an adjunct to the operating microscope in this area.METHODSThe pulvinar was examined in 6 formalin-fixed human cadaveric heads through 5 approaches: 4 above and 1 below the tentorium. Each approach was performed using both the surgical microscope and 0° or 45° rigid endoscopes.RESULTSThe pulvinar has a lateral ventricular and a medial cisternal surface that are separated by the fornix and the choroidal fissure, which wrap around the posterior surface of the pulvinar. The medial cisternal part of the pulvinar can be further divided into upper and lower parts. The superior parietal lobule approach is suitable for lesions in the upper ventricular and cisternal parts. Interhemispheric precuneus and posterior transcallosal approaches are suitable for lesions in the part of the pulvinar forming the anterior wall of the atrium and adjacent cisternal part. The posterior interhemispheric transtentorial approach is suitable for lesions in the lower cisternal part and the supracerebellar infratentorial approach is suitable for lesions in the inferior and medial cisternal parts.The microscope provided satisfactory views of the ventricular and cisternal surfaces of the pulvinar and adjacent neural and vascular structures. The endoscope provided multi-angled and wider views of the pulvinar and adjacent structures.CONCLUSIONSA combination of endoscopic and microsurgical techniques allows optimal exposure of the pulvinar.

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Section: Discussionmentioning

confidence: 99%

“…This approach to the cisternal surface is appropriate for patients without hydrocephalus because the operation can be easily performed from the midline. 27 Microscopic View. After opening the corpus callosum, the first structures seen are the internal cerebral veins covered with tela choroidea.…”

mentioning

confidence: 99%

Microsurgical and endoscopic approaches to the pulvinar

Akiyama

Matsushima

Güngör

et al. 2017

Journal of Neurosurgery

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“…Of these publications, 20 were case series (Table). 1,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Histologically, the vast majority (70%-90%) of reported thalamic tumors are classified as astrocytoma. However, this literature is limited and difficult to interpret regarding histologic subtypes in children, as many studies combine age groups, are confined to more specific entities (eg, pilocytic astrocytoma (PA) or ''high-grade astrocytoma''), group biologically distinct entities (eg, PA and low-grade diffuse astrocytoma [DA] as ''low-grade astrocytoma''), or are single case reports.…”

Section: Epidemiologymentioning

confidence: 99%

“…But with improved surgical techniques, total or partial resection is now more frequently performed, particularly for noninfiltrating, low-grade tumors. [1][2][3][4][5][6][7][8][9][10][11][12][13] Additionally, children with even incompletely resected low-grade thalamic gliomas can have a 5-year overall survival rate greater than 80% with adjuvant chemotherapy and radiation. 13,14 Therefore, histologic verification is now thought to be critical for planning treatment, and, as a result, biopsy and total/subtotal resections are much more common today than in the past.…”

mentioning

confidence: 99%

Pediatric Thalamic Gliomas: An Updated Review

Gupta¹,

Shaller

McFadden³

2017

Archives of Pathology &Amp; Laboratory Medicine

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Context.-Neoplasms originating in the thalamus are rare overall (1% of all brain tumors); however, they comprise approximately 5% of pediatric intracranial tumors and approach 15% of all malignant pediatric intracranial tumors in some series.Objective.-To update readers about the current understanding of the diverse histology, biology, and behavior of pediatric thalamic tumors. Histologic verification is now thought to be critical for planning treatment, and, as a result, biopsy and total/subtotal resections are much more common today than in the past.Data Sources.-A PubMed search using the keywords ''pediatric þ thalamic þ glioma'' yielded 45 publications with a total of 445 cases of thalamic gliomas in patients less than 18 years of age. We found only 9 substantial institutional series tabulating all encountered thalamic histologic types in children. This survey confirmed a high proportion of astrocytomas, 81% (214 of 265), of which approximately two-thirds were diffuse astrocytomas (146 of 214) and one-third were pilocytic astrocytomas (68 of 214). Of the diffuse astrocytomas, 34% (49 of 146) were low grade (World Health Organization grade II) and 55% (81 of 146) were high grade (World Health Organization grade III or IV), making the latter subgroup the largest single category of all pediatric thalamic tumors. Oligodendrogliomas and ependymomas (mostly anaplastic in both cases) comprised 10% and 3% of all pediatric thalamic tumors, respectively.Conclusions.-Tissue diagnosis is now thought crucial for prognostication and treatment, particularly as more potentially therapeutic molecular targets are discovered. Secure diagnosis allows identification of tumors for which resection is more feasible and beneficial.

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“…[4] Complete excision of benign tumors can be curative while the resection of high grade tumors confers a survival advantage. [1,[5][6][7] Three distinguishable patterns of expansion and growth for thalamic tumors have been described by Yasargil. [8] approaches may penetrate a substantial depth of the cortex to reach the target.…”

Section: Surgical Techniquementioning

confidence: 99%