Zusammenfassung
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Abstract
Objective and Importance: It has been difficult to obtain a biopsy of a midbrain lesion. In addition, proper
cerebrospinal fluid diversion should be secured because progressing tumor in the midbrain
causes obstructive hydrocephalus. We report on the superiority of flexible neuroendoscopy
to treat progressing midbrain tumor.
Clinical Presentation: A 64-year-old man presented with an occasional double vision. A magnetic resonance
imaging scan disclosed an enhancing lesion in the midbrain.
Intervention: We performed a neuroendoscopic biopsy of the tumor and third ventriculostomy. Neuroendoscopy
confirmed a bulging of the posterior commissure, which caused stenosis of the entrance
of the aqueduct. Histological examination of the specimen obtained disclosed a diffuse
astrocytoma. No permanent postoperative complications occurred although the patient
felt slight double vision for 2 days after the operation. Conventional radiation therapy
was supplemented.
Conclusion: Flexible neuroendoscopic biopsy with third ventriculostomy was a less-invasive and
safer alternative for the progressing midbrain tumor bulging into the ventricles.
Key words
Endoscopy - hydrocephalus - biopsy
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T. Nishikawa,M. D., Ph. D.
Osaka Saiseikai Izuo Hospital
Kitamura 3-4-5, Taisyo-ku
Osaka, 551-0032
Japan
Phone: +81-6-6552-0091
Fax: +81-6-6552-0560
Email: tom@nishikawa.org
