Combined microsurgical-endoscopic paramedian supracerebellar-infratentorial approach for resection of a pineal low-grade glioma.

• Authors: Juan Revuelta Barbero, Emory University; Roberto M Soriano, Emory University; Rima S Rindler, Emory University; David P Bray, Emory University; Oswaldo Henriquez, Emory University; Arturo C Solares, Emory University; Gustavo Pradilla, Emory University
• Journal Title: Neurosurg Focus Video
• Volume: Volume 5, Number 1
• Publisher: American Association of Neurological Surgeons | 2021-07, Pages V9-V9
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.3171/2021.4.FOCVID2119
• Subjects: Health Sciences, Medicine and Surgery
• Keywords: infratentorial suprasellar approach; minimal invasive approach; pineal region

Abstract

The authors present the case of a 20-year-old male with a history of headaches and blurred vision found to have a pineal mass and chronic hydrocephalus. The patient initially underwent an endoscopic third ventriculostomy and pineal mass biopsy that revealed a low-grade neuroepithelial neoplasm. A microsurgery-endoscope-assisted paramedian supracerebellar-infratentorial approach was chosen and a gross-total resection was achieved. The patient's postoperative and follow-up course has been unremarkable, with early postoperative imaging demonstrating no residual tumoral mass. The operative video highlights the advantages of endoscopic visualization for deep lesions in the pineal region and posterior third ventricle. The video can be found here: https://stream.cadmore.media/r10.3171/2021.4.FOCVID2119.