• Bianca Bossi, Luca Ferlendis, Désirée Dallago, Immacolata Mazzetto, Marco Scarlino, Antonio Tabano, and Davide Locatelli.
• Division of Neurosurgery, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy. Electronic address: b.bossi@unibs.it.
• World Neurosurg. 2024 Oct 5.

BackgroundIntraventricular cavernous malformations (IVCs) are rare vascular lesions of the central nervous system. Surgical resection remains a challenging endeavor, with conventional microsurgical techniques associated with morbidity due to direct brain tissue manipulation. Neuroendoscopic approaches offer a minimally invasive alternative, though their efficacy and safety in treating IVCs remain underexplored.MethodsA narrative review was conducted to analyze all documented cases of IVCs treated exclusively with endoscopic transventricular approaches (ETVA). Reviews, original research papers, and case reports published from 1990 to May 2024 were included. When available, surgical videos were also reviewed.ResultsSeventeen patients with IVCs primarily located in the foramen of Monro were identified. The mean size of the IVCs was 17 mm (range 7-29 mm). Neuroendoscopic procedures achieved gross total resection in all cases, leading to the resolution of clinical symptoms. Except for one patient who experienced memory impairment post-surgery, no persistent neurological dysfunctions were observed. Intraoperative bleeding, a significant challenge in IVC resection, was managed with continuous warm irrigation and dedicated coagulation instruments. Additionally, 6 cases of neuroendoscopic procedures such as endoscopic third ventriculostomy (ETV) and septum pellucidotomy were reported for managing hydrocephalus (HCP).ConclusionNeuroendoscopic surgery offers several advantages in treating IVCs, including minimally invasive access, precise visualization, and reduced brain tissue manipulation. Our findings support the efficacy and safety of ETVA, underscoring its potential as a valuable therapeutic strategy for selected IVCs.Copyright © 2024 Elsevier Inc. All rights reserved.

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