Endoscopic Transforaminal Transchoroidal Approach to the Third Ventricle for Cystic and Solid Tumors.

Background: Endoscopic access to the third ventricle is limited by the confinements of the foramen of Monro and can be aided by opening of the choroidal fissure.

Objective: We describe the endoscopic transforaminal transchoroidal (ETTC) approach to the third ventricle with opening of the choroidal fissure to enlarge the posterior foramen of Monro for treatment of various third ventricular diseases.

Methods: We completed a retrospective review of a prospectively collected database at 3 tertiary academic facilities.

Near-Infrared Confocal Laser Reflectance Cytoarchitectural Imaging of the Substantia Nigra and Cerebellum in the Fresh Human Cadaver.

Background: Cytoarchitectural neuroimaging remains critical for diagnosis of many brain diseases. Fluorescent dye-enhanced, near-infrared confocal in situ cellular imaging of the brain has been reported. However, impermeability of the blood-brain barrier to most fluorescent dyes limits clinical utility of this modality.

Endoscopic Third Ventriculostomy in 250 Adults With Hydrocephalus: Patient Selection, Outcomes, and Complications.

Background: Endoscopic third ventriculostomy (ETV) has been used predominantly in the pediatric population in the past. Application in the adult population has been less extensive, even in large neurosurgical centers. To our knowledge, this report is one of the largest adult ETV series reported and has the consistency of being performed at 1 center.

Transciliary supraorbital approach (eyebrow approach) for resection of retrochiasmatic craniopharyngiomas: an alternative approach, case series, and literature review.

Introduction: Craniopharyngiomas are known for an irregular growth pattern and extension into the retrochiasmatic space with adherence to adjacent structures. We describe the use of the transciliary supraorbital approach (eyebrow approach) for resection of craniopharyngiomas with retrochiasmatic extension.

Methods: Our clinical database was reviewed to identify operative cases of craniopharyngiomas between July 1998 and January 2011.

An episode of severely suppressed electrocerebral activity recorded by electroencephalography during endoscopic resection of a colloid cyst.

Intraoperative neuromonitoring utilizing electroencephalography (EEG) is rarely performed during neuroendoscopy. The authors present a case in which this monitoring modality was used for a patient with a colloid cyst in preparation for an open craniotomy should an endoscopic approach fail. In this case, EEG serendipitously captured near-complete cessation of electrocerebral activity that occurred during intraventricular irrigation in response to ventricular collapse and resulted in no postoperative deficits.

Endoscopic third ventriculostomy for hydrocephalus after perimesencephalic subarachnoid hemorrhage: initial experience in three patients.

Background: To review the outcome after endoscopic third ventriculostomy (ETV) for symptomatic, persistent hydrocephalus in three patients with perimesencephalic angiographically negative subarachnoid hemorrhage (PNH) who were dependent on an external ventricular drain (EVD).

Methods: All patients initially presented with severe headache, nuchal rigidity, confusion and lethargy (Hunt-Hess Grade II or III), and persistent, EVD-dependent hydrocephalus. Cranial CT images in each revealed acute hydrocephalus and perimesencephalic hemorrhage pattern with a heavy clot burden (Fisher grade 3).

Endoscopic third ventriculostomy in adults: a technique for dealing with the neural (opaque) floor.

Object: An opaque (neural) floor of the third ventricle is considered an obstacle to safe penetration of the floor of the third ventricle in endoscopic third ventriculostomy (ETV). The direct technique of endoscopic coring ("cookie cut") of the opaque (neural) floor of the third ventricle is described in 41 cases among a total of 101 consecutive adult ETVs.

Methods: A 0° endoscope in a 4.

Endoscopic cauterization of a symptomatic choroid plexus cyst at the foramen of Monro: case report.

Objective: Choroid plexus cysts are common in the developing fetus, and although often persisting into adulthood, they rarely represent the underlying cause of symptomatic unilateral ventriculomegaly. The case presented here highlights both the diagnostic obscurity and endoscopic management of a choroid plexus cyst in a symptomatic patient.

Clinical Presentation: The patient is a 47-year-old white woman who presented with acute exacerbation of debilitating, diffuse, and postural headache, nausea, vomiting, early papilledema, and short-term memory loss.

Delayed stoma failure in adult communicating hydrocephalus after initial successful treatment by endoscopic third ventriculostomy: case report.

Objective: To describe 2 cases of delayed endoscopic third ventriculostomy (ETV) failure in 2 adult patients initially successfully treated for normal pressure hydrocephalus by ETV. The cause of ETV failure was stoma closure, and this was documented in both instances by direct endoscopic inspection.

Clinical Presentation: In the first case, a 67-year-old woman presented with progressive gait disturbance, incontinence, and memory problems.

Posterior cerebral artery P1 segment at the stoma during endoscopic third ventriculostomy in adults.

Objectives: A serious catastrophic complication of endoscopic third ventriculostomy (ETV) is basilar artery (BA) damage. Although the BA has been discussed as the cause of haemorrhage and even pseudoaneurysm, variations of the posterior cerebral artery proximal segment (P1) and its protrusion into the third ventricle floor have not been emphasised. A series of cases are reported in which the P1 segment was located at the stoma during an ETV and was at risk of perforation.

Enlarged thalamostriate vein causing unilateral Monro foramen obstruction. Case report.

Causes of unilateral hydrocephalus resulting from an obstruction at the Monro foramen include foraminal atresia, tumors, gliosis, contralateral shunting, and infectious and inflammatory conditions. However, few reports in the literature cite vascular lesions as the cause of the obstruction. To their knowledge, the authors present the first report of unilateral hydrocephalus occurring due to an abnormally enlarged thalamostriate vein independent of an arteriovenous malformation or developmental venous angioma.

Neural-dural transition at the medial anterior cranial base: an anatomical and histological study with clinical applications.

Object: Few anatomical studies have been focused on the morphological features and microscopic anatomy of the transition from the intracranial space to the medial anterior cranial base. The authors of the current study performed histological analyses to define the structure of the transition from neural foramina to the cranial base (neural-dural transition) at the cribriform plate, particularly as related to cerebrospinal fluid (CSF) fistula formation and surgical intervention in the region.

Methods: The medial anterior cranial base was resected in six cadaveric specimens.