• Domagoj Jugović, Peter Spazzapan, Andrej Porčnik, and Borut Prestor.
• 1Department of Neurosurgery, Bamberg General Hospital, Bamberg, Germany; 2University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia; 3Department of Neurosurgery, University Medical Centre Ljubljana, Ljubljana, Slovenia.
• Acta Clin Croat. 2020 Sep 1; 59 (3): 549-554.

AbstractWe report a case of trans-endoscopic transventricular approach to a large cystic craniopharyngioma. Surgery was performed three days after visual acuity on both eyes deteriorated to blindness. Magnetic resonance imaging before surgery revealed a large lesion in the suprasellar region that severely compressed the optic chiasm and displaced the third ventricle upward. The lesion was operated through the trans-endoscopic transventricular approach, with the aim of urgent decompression of the optic apparatus. At first, wide ventriculo-cysto-cisternostomy was performed, and then tumor tissue was removed. Postoperatively, visual acuity significantly improved on one eye. Our case shows that this minimally invasive technique is safe and effective and can be an alternative treatment for large cystic craniopharyngiomas. The reported case also shows that loss of vision can still be recovered even after the 72-hour period in adults.

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