Introduction: In ventricular tumours causing obstructive hydrocephalus neuroendoscopy has gained even more appeal as a first choice procedure since it is possible to simultaneously perform tumour biopsy and endoscopic third ventriculostomy (ETV) or septostomy. The immediate relief of intracranial hypertension and the availability of specimens for a pathological diagnosis allow time for planning the most suitable treatment strategy based on histological diagnosis and CSF tumour markers. In fact, in a subset of ventricular or paraventricular tumours further surgical ablation is not required and the endoscopic procedure may be the only surgical procedure necessary.
Methods: A total of 22 patients with new diagnosed intra-or paraventricular tumours and ventricular dilation at MRI underwent neuroendoscopic biopsy. Age ranged from 8 to 79 years. No patient affected by colloid cyst was included. The tumour was in 13 in the lateral ventricle, in 9 in the third ventricle. Data on clinical presentation, neuroimaging, operative techniques, pathological diagnosis, postoperative complications and subsequent therapy were analyzed
Results: In 21 patients neuroendoscopic tumour biopsy was performed. In addition to the tumor biopsy, 9 patients underwent endoscopic third ventriculostomy (ETV) and 5 septum pellucidotomy. In 8 patients with vascularized tumour, the Tu laser was helpful. In 20 tumours histological diagnosis was obtained. According to diagnosis, specific therapy was performed.
Conclusions: Based on our experience, the neuroendoscopic biopsy should be considered in the diagnosis and therapy of ventricular tumours, allowing subsequent tumor therapy. Furthermore, CSF pathways can be restored by ETV or septum pellucidotomy (66%) to control intracranial hypertension.
Patient Care: developping the correct approach to ventricular tumors by neuroendoscopy
Learning Objectives: By the conclusion of this session, participants should be able to 1)describe the importance of decision making in ventricular tumors therapy 2) discuss in small groups on the indications for neuroendoscopy 3) identify an effective treatment for ventricular tumors