CC BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2018; 79(S 03): S281-S282
DOI: 10.1055/s-0038-1625967
Skull Base: Operative Videos
Georg Thieme Verlag KG Stuttgart · New York

Gross Total Resection of Chordoid Glioma of the Third Ventricle via Anterior Interhemispheric Transcallosal Transforaminal Approach at Two Stages

Ihsan Dogan
1   Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
,
Melih Ucer
1   Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
,
Mustafa Kemal Başkaya
1   Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
› Author Affiliations
Further Information

Address for correspondence

Mustafa Kemal Başkaya, MD
Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health
600 Highland Avenue, K4/8 CSC, Box 8660, Madison, WI 53792
United States   

Publication History

17 October 2017

03 December 2017

Publication Date:
16 February 2018 (online)

 

Abstract

Suprasellar tumors in particular tumors located in the retrochiasmatic area and anterior third ventricle are challenging cases in terms of optimal surgical exposure. Several approaches have been described including transsylvian, translamina terminalis, endoscopic endonasal, and anterior interhemispheric. Each approach has advantages and disadvantages. In this video, we present a case of retrochiasmatic anterior third ventricular tumor that was operated via anterior interhemispheric transcallosal transforaminal approach. The patient is a 42-year-old female who presented with sudden onset of severe headache and depressed level of consciousness. Computed tomography (CT) scan of the head showed a hemorrhage in the third ventricle and suprasellar cisterns. CT angiogram and magnetic resonance imaging (MRI) confirmed diagnosis of hemorrhagic mass lesion in the third ventricle. Upon further questioning of her family, we found out that she was having excessive urination and short-term memory problems for last 2 weeks. First, ventriculostomy was placed for obstructive hydrocephalus. She then underwent surgical resection via anterior interhemispheric transcallosal transforaminal approach. Foramen of Monro was enlarged by performing transchoroidal dissection. Using transforaminal route, tumor was resected. Due to the narrow surgical corridor and high vascularity of the tumor, decision was made to come back at a second stage. Using same surgical approach, in the second stage, gross total resection was performed. Postoperative MRI confirmed gross total resection. Histopathology was chordoid glioma of the third ventricle. She made excellent recovery with persistent diabetes insipidus. Currently, she is completing radiation therapy. In this video, we demonstrate techniques and pitfalls of anterior interhemispheric transcallosal approach to anterior third ventricular tumor.

The link to the video can be found at: https://youtu.be/CI5c6Zup8sY.


#

www.thieme.com/skullbasevideos

www.thieme.com/jnlsbvideos


Quality:

#

Conflict of Interest

None.

Address for correspondence

Mustafa Kemal Başkaya, MD
Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health
600 Highland Avenue, K4/8 CSC, Box 8660, Madison, WI 53792
United States