World Neurosurg
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Intraventricular cystic tumors constitute a surgical challenge, because of their deep location and the histologically benign nature of most of them. We aim to present concisely, yet comprehensively, the role of neuroendoscopy in the treatment of intraventricular cystic tumors. ⋯ Intraventricular endoscopy has emerged as a viable option in the treatment of intraventricular cystic tumors.
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Advances in neuroendoscopy have accommodated the development of intraventricular techniques that enhance the management of multiple disease processes. Tumors of the pineal region are amenable to endoscopic management in that they are accessible through the third ventricle and commonly cause hydrocephalus that can be alleviated by endoscopic third ventriculostomy (ETV). We describe the indications for and procedure of simultaneous ETV and biopsy of pineal region tumors, as well as the clinical features favoring different approaches to this procedure. ⋯ Simultaneous ETV and tumor biopsy is a valuable technique that can be used to manage hydrocephalus and establish diagnosis in patients with newly diagnosed pineal region tumors, potentially avoiding traditional craniotomy and ventriculoperitoneal shunt placement. It is favored as an early step in the management of patients with marker-negative tumors.
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To describe the neuroendoscopic technique to deal with intraventricular tumors. ⋯ Intraventricular tumors and related CSF pathway obstructions can be safely and effectively treated with endoscopic techniques. Small tumors may be totally removed via a ventriculoscope.
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Interhemispheric and quadrigeminal cysts are rare lesions, similar in their propensity to present in young babies and to be associated with other central nervous system malformations, such as corpus callosum agenesia, holoprosencephaly, encephalocele, and neuronal heterotopias. Recently endoscopy has become increasingly popular in the treatment of arachnoid cysts, but experience with cysts located in the interhemispheric fissure and in the quadrigeminal cistern is limited. ⋯ Endoscopic treatment should be considered the first-line option in the treatment of such lesions, even if some complications, such as subdural collections due to thinness of the cerebral mantle or subcutaneous CSF collections due to multifactorial associated hydrocephalus, must be expected.
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Case Reports Historical Article
Sellar door: Harvey Cushing's entry into the pituitary gland, the unabridged Johns Hopkins experience 1896-1912.
To review the original surgical records from the Johns Hopkins Hospital, and analyze the records of patients Cushing treated for pituitary disorders from 1896 to 1912. ⋯ This review highlights Cushing's accomplishments in the surgical treatment of suspected pituitary pathology during his early career as a young attending at Johns Hopkins Hospital. It reveals new information about patients whom Cushing did not include in his publications detailing his surgical experience at the Johns Hopkins Hospital.