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  1 / 3053 MEDLINE  
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[PMID]:27778210
[Au] Autor:Winkler EA; Birk H; Safaee M; Yue JK; Burke JF; Viner JA; Pekmezci M; Perry A; Aghi MK; Berger MS; McDermott MW
[Ad] Endereço:Department of Neurological Surgery, University of California San Francisco, 505 Parnassus Avenue, M-779, San Francisco, CA, 94143-0112, USA.
[Ti] Título:Surgical resection of fourth ventricular ependymomas: case series and technical nuances.
[So] Source:J Neurooncol;130(2):341-349, 2016 11.
[Is] ISSN:1573-7373
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Ependymomas are rare neuroepithelial tumors which may arise anywhere along the ventricular system. Tumors arising in the fourth ventricle present unique challenges. Complete tumor resection favors prolonged survival, but may result in inadvertent injury of surrounding neural structures-such as cranial nerve (CN) nuclei. Here, our institutional experience with surgical resection of fourth ventricular ependymomas is described. A single institution, retrospective analysis of consecutive case series of adult surgically resected fourth ventricular ependymomas with the bilateral telovelar approach. Extent of resection, outcomes and postoperative complications are statistically analyzed. From January 2000 to April 2016, 22 fourth ventricular ependymomas underwent surgical resection. Gross total resection was achieved in 18 of 22 cases (82 %). There were six postoperative CN palsies-3 lower CN palsies (IX, X, or XI), 1 CN VII palsy, 1 CN IV palsy, and 1 CN VI palsy. No deaths or cerebellar mutism occurred. Two of 6 CN deficits resolved and the rate of permanent neurologic deficit was 18 %. A CN deficit was not statistically associated with prolonged hospital stay or functional outcome. With exception of one patient, all patients functionally improved or remained unchanged following surgery. Postoperative complications included one wound infection (4.5 %) and four pseudomeningoceles (18 %). The rate of shunt-dependent hydrocephalus was 18 %. Tumors adherence to the fourth ventricular floor is not an absolute contraindication for complete resection. Intraoperative neuro-monitoring is essential, and the development of sustained, but not transient CN activity, and/or hemodynamically significant bradycardia should limit the extent of resection.
[Mh] Termos MeSH primário: Neoplasias do Ventrículo Cerebral/cirurgia
Ependimoma/cirurgia
Quarto Ventrículo/cirurgia
Procedimentos Neurocirúrgicos
[Mh] Termos MeSH secundário: Seres Humanos
Tempo de Internação
Procedimentos Neurocirúrgicos/efeitos adversos
Complicações Pós-Operatórias
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180202
[Lr] Data última revisão:
180202
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161103
[St] Status:MEDLINE


  2 / 3053 MEDLINE  
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[PMID]:28847111
[Au] Autor:Sharma S
[Ad] Endereço:Department of Neurosurgery, Trivandrum Medical College, Kerala, India. Electronic address: ashu20030000@gmail.com.
[Ti] Título:Rosette-Forming Glioneuronal Tumor Arising from the Spinal Cord.
[So] Source:World Neurosurg;105:1001, 2017 09.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Neoplasias Neuroepiteliomatosas
Medula Espinal
[Mh] Termos MeSH secundário: Neoplasias do Ventrículo Cerebral
Quarto Ventrículo
Ganglioglioma
Seres Humanos
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170830
[St] Status:MEDLINE


  3 / 3053 MEDLINE  
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[PMID]:28648908
[Au] Autor:Beechar VB; Srinivasan VM; Reznik OE; Sen A; Klisch TJ; Ropper AE; Mandel JJ; Heck KA; Seipel TJ; Patel AJ
[Ad] Endereço:Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.
[Ti] Título:Intraventricular Cavernomas of the Third Ventricle: Report of 2 Cases and a Systematic Review of the Literature.
[So] Source:World Neurosurg;105:935-943.e3, 2017 Sep.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Intraventricular cavernous malformations are relatively rare benign vascular malformations. Patients may be asymptomatic or present with headache, seizure, hemorrhage, or neurologic deficits. We report 2 cases of patients with cavernomas in the third ventricle and at the foramen of Monro. We also performed a systematic review of the literature to examine the clinical features and efficacy of the current standard of care for these lesions. METHODS: We performed the systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Multiple databases were queried; the title/abstract and MeSH keywords used included "cavernous malformation," "cavernoma," "cavernous hemangioma," "cavernous angioma," "foramen of Monro," "third ventricle," and "intraventricular," along with "AND" and "OR" operators. Patient demographic and clinical data were collected for qualitative synthesis. RESULTS: Patients presented at a median age of 38 years; the most common symptom was headaches. Gross total resection was performed in 84.6% of patients, and 81.8% had clinical improvement with intervention. The incidence of intraventricular hemorrhage and hydrocephalus was 15.4% and 59%, respectively. CONCLUSIONS: The specific location of the cavernoma determines clinical features seen and approach used in surgical resection. Ventriculoperitoneal shunting was not required in most cases, as hydrocephalus improved with removal of the obstruction at the foramen of Monro. Gross total resection appears to be the optimal management strategy in symptomatic patients and leads to a good outcome in most cases.
[Mh] Termos MeSH primário: Neoplasias do Ventrículo Cerebral/cirurgia
Hemangioma Cavernoso do Sistema Nervoso Central/etiologia
Hemangioma Cavernoso/cirurgia
Hidrocefalia/etiologia
Terceiro Ventrículo/cirurgia
[Mh] Termos MeSH secundário: Adulto
Neoplasias do Ventrículo Cerebral/complicações
Neoplasias do Ventrículo Cerebral/diagnóstico
Feminino
Cefaleia/etiologia
Hemangioma Cavernoso/complicações
Hemangioma Cavernoso/diagnóstico
Hemangioma Cavernoso do Sistema Nervoso Central/diagnóstico
Hemangioma Cavernoso do Sistema Nervoso Central/cirurgia
Seres Humanos
Hidrocefalia/diagnóstico
Masculino
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170627
[St] Status:MEDLINE


  4 / 3053 MEDLINE  
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[PMID]:28562734
[Au] Autor:Campos Paiva AL; Vitorino Araujo JL; Ferraz VR; Esteves Veiga JC
[Ad] Endereço:MD. Neurosurgery Resident, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo (SP), Brazil.
[Ti] Título:Simultaneous meningioma and brain metastasis from renal cell carcinoma - a rare presentation. Case report.
[So] Source:Sao Paulo Med J;135(3):296-301, 2017 May-Jun.
[Is] ISSN:1806-9460
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:CONTEXT:: Brain metastases are the most common tumors of the central nervous system. Because of their high frequency, they may be associated with rare situations. Among these are tumor-to-tumor metastasis and an even a rarer situation called simultaneous brain tumors, which are more related to primary tumors of the reproductive and endocrine systems. CASE REPORT:: A 56-year-old male patient with a history of renal cell carcinoma (which had previously been resected) presented with a ventricular lesion (suggestive of metastatic origin) and simultaneous olfactory groove lesion (probably a meningioma). First, only the ventricular lesion was dealt with, but after a year, the meningothelial lesion increased and an occipital lesion appeared. Therefore, both of these were resected in a single operation. All the procedures were performed by the same neurosurgeon. The patient evolved without neurological deficits during the postoperative period. After these two interventions, the patient remained well and was referred for adjuvant treatment. CONCLUSIONS:: This study provides the first description of an association between these two tumors. Brain metastases may be associated with several lesions, and rare presentations such as simultaneity with meningioma should alert neurosurgeons to provide the best oncological treatment.
[Mh] Termos MeSH primário: Carcinoma de Células Renais/secundário
Neoplasias do Ventrículo Cerebral/secundário
Neoplasias Renais/patologia
Neoplasias Meníngeas/secundário
Meningioma/secundário
[Mh] Termos MeSH secundário: Neoplasias do Ventrículo Cerebral/diagnóstico por imagem
Neoplasias do Ventrículo Cerebral/cirurgia
Seres Humanos
Imuno-Histoquímica
Imagem por Ressonância Magnética
Masculino
Neoplasias Meníngeas/diagnóstico por imagem
Neoplasias Meníngeas/cirurgia
Meningioma/diagnóstico por imagem
Meningioma/cirurgia
Meia-Idade
Doenças Raras
Tomografia Computadorizada por Raios X
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170929
[Lr] Data última revisão:
170929
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170601
[St] Status:MEDLINE


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[PMID]:28259671
[Au] Autor:Almefty RO; Patel NJ; See AP; Dunn IF; Al-Mefty O; Aziz-Sultan MA
[Ad] Endereço:Department of Neurosurgery, Brigham and Women Hospital, Harvard School of Medicine, Boston, Massachusetts, USA; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA. Electronic address: rami.almefty@bnaneuro.net.
[Ti] Título:Hybrid Surgery Management of Giant Hypervascular Tumors: Intraoperative Endovascular Embolization with Microsurgical Resection.
[So] Source:World Neurosurg;102:157-166, 2017 Jun.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Giant hypervascular intracranial tumors represent a formidable challenge because their size limits surgical control of the blood supply and debulking poses the risk of critical blood loss. Embolization facilitates resection but carries the risk of life-threatening tumor infarction, hemorrhage, or swelling if performed preoperatively. Endovascular intraoperative embolization avoids the fatal risk and allows the surgeon to attend instantly if any complication occurs. METHODS AND RESULTS: We report 2 cases in which combining intraoperative embolization with microsurgical resection in the hybrid operating room was used to safely and successfully remove giant hypervascular tumors. CONCLUSIONS: Intraoperative embolization facilitates the safe resection of giant hypervascular tumors and mitigates the consequences of potential tumor infarction, hemorrhage, or swelling from embolization. These cases exemplify the benefits of combining expertise in endovascular and microsurgical techniques with the capabilities of modern hybrid operating rooms allowing for their simultaneous application.
[Mh] Termos MeSH primário: Neoplasias do Ventrículo Cerebral/cirurgia
Embolização Terapêutica/métodos
Neoplasias Meníngeas/cirurgia
Meningioma/cirurgia
Microcirurgia/métodos
[Mh] Termos MeSH secundário: Adulto
Neoplasias do Ventrículo Cerebral/diagnóstico por imagem
Angiografia por Tomografia Computadorizada
Feminino
Gadolínio/metabolismo
Seres Humanos
Imagem Tridimensional
Masculino
Neoplasias Meníngeas/diagnóstico por imagem
Meningioma/diagnóstico por imagem
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
AU0V1LM3JT (Gadolinium)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170306
[St] Status:MEDLINE


  6 / 3053 MEDLINE  
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[PMID]:28257949
[Au] Autor:Wang X; Liu YH; Mao Q
[Ad] Endereço:Department of Neurosurgery, West China Hospital of Sichuan University, China. Electronic address: wangxiangtim@gmail.com.
[Ti] Título:Retractorless surgery for third ventricle tumor resection through the transcallosal approach.
[So] Source:Clin Neurol Neurosurg;155:58-62, 2017 Apr.
[Is] ISSN:1872-6968
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Resection of tumors of the third ventricle through the transcallosal-interforniceal approach presents a surgical challenge with potential serious postoperative neurological deficits and complications. Retraction injury of the deep brain tissue and veins is a possible reason. Here, we aimed to investigate the feasibility and value of retractorless surgery in third ventricle tumor resection. PATIENTS AND METHODS: Since 2014, a total of 31 patients with third ventricle tumors were operated in our institution. All patients were operated using the transcallosal-interforniceal approach with a straight incision. The use of self-retaining retractor or constant retraction was not allowed. At the end of surgery, the opening of corpus callosum was sealed with fibrin glues. The degrees of tumor resection and postoperative neurological function deficits as well as complications were analyzed. The effect of retractorless surgery was evaluated according to the brain edema around the surgical approach on T2 imaging. RESULTS: Thirty-one tumors were located in the anterior, middle, and posterior of the third ventricle. Total or gross total resection was achieved in 25 patients (80.6%). Postoperative neurological function deficits occurred in 4 patients (12.9%), and patients with mutism had a good recovery 3 weeks post-surgery. Retraction injuries around the surgical pathway were not obvious on T2 imaging. In addition, no subdural hygroma and subcutaneous fluid accumulation occurred. CONCLUSIONS: The application of retractorless surgery in third ventricle tumors is feasible with enough exposure of tumors. This application could decrease the occurrence of postoperative neurological deficits and complications by avoiding the retraction injury on the deep brain structures.
[Mh] Termos MeSH primário: Neoplasias do Ventrículo Cerebral/cirurgia
Corpo Caloso/cirurgia
Procedimentos Neurocirúrgicos
Terceiro Ventrículo/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Neoplasias do Ventrículo Cerebral/patologia
Corpo Caloso/patologia
Feminino
Seres Humanos
Masculino
Microcirurgia/métodos
Meia-Idade
Procedimentos Neurocirúrgicos/métodos
Período Pós-Operatório
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170420
[Lr] Data última revisão:
170420
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170305
[St] Status:MEDLINE


  7 / 3053 MEDLINE  
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[PMID]:28120072
[Au] Autor:Soliman WS
[Ad] Endereço:Faculty of Medicine, Cairo University, Cairo, Egypt. wessamsoliman75@yahoo.com.
[Ti] Título:Ventricular Central Neurocytoma: Rate of Shunting and Outcome 2 Years After Total and Subtotal Excision.
[So] Source:Acta Neurochir Suppl;124:179-185, 2017.
[Is] ISSN:0065-1419
[Cp] País de publicação:Austria
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Central neurocytoma is an intraventricular tumor that affects young adults. It has a favorable prognosis after adequate surgical intervention; however, an aggressive course may take place in some cases. OBJECTIVE: The objective of the study was to evaluate the rate of shunting and the outcome of control measures in patients with central neurocytoma submitted to total and subtotal excision. METHODS: Twelve patients were included in this study, with a follow-up of 24 months. Data collected included: age, sex, clinical presentation, early morbidity and mortality, radiological findings (tumor location, features, residual, recurrence, and hydrocephalus). All patients underwent surgery for total or subtotal excision through a transcortical approach. External Ventricular Drain (EVD) was inserted then removed or replaced by a shunt. Histopathology and the MIB index were used to confirm diagnosis and guide the follow-up; adjuvant radiotherapy or Gamma Knife radiosurgery were used for residual tumor or recurrence. RESULTS: The ages of the patients ranged from 14 to 48 years. Two patients died early, after total and subtotal excision, from sepsis and thalamic infarction, respectively. Six patients (60 %) had a total excision; two of them had a high MIB index and showed small recurrence at 12 months and 18 months, respectively, and received Gamma Knife radiosurgery. One of the six patients with total excision needed a shunt, and no shunt was needed in the four otherpatients; a subtotal excision was done for four patients (40 %). An early shunt was inserted for two of these patients, radiosurgery-controlled for one patient, while radiotherapy was used for control in the other three patients; radiotherapy control failed in one patient, who underwent a second surgery at 18 months. CONCLUSION: Central neurocytoma may have a favorable prognosis, with a lower incidence of shunt insertion throughout its course than that for other intraventricular tumors, if total removal is achieved.
[Mh] Termos MeSH primário: Neoplasias do Ventrículo Cerebral/cirurgia
Hidrocefalia/cirurgia
Neurocitoma/cirurgia
Procedimentos Neurocirúrgicos/métodos
Derivação Ventriculoperitoneal/utilização
[Mh] Termos MeSH secundário: Adolescente
Adulto
Neoplasias do Ventrículo Cerebral/complicações
Neoplasias do Ventrículo Cerebral/diagnóstico por imagem
Drenagem
Feminino
Seguimentos
Seres Humanos
Hidrocefalia/etiologia
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Recidiva Local de Neoplasia/radioterapia
Neoplasia Residual
Neurocitoma/complicações
Neurocitoma/diagnóstico por imagem
Radiocirurgia
Radioterapia Adjuvante
Ventriculostomia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170126
[St] Status:MEDLINE
[do] DOI:10.1007/978-3-319-39546-3_28


  8 / 3053 MEDLINE  
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[PMID]:28120058
[Au] Autor:Oppido PA
[Ad] Endereço:Neurosurgical Department, Regina Elena National Cancer Institute, Via Elio Chianesi 53, Rome, 00144, Italy. piero.oppido@ifo.gov.it.
[Ti] Título:Endoscopic Reconstruction of CSF Pathways in Ventricular Tumors.
[So] Source:Acta Neurochir Suppl;124:89-92, 2017.
[Is] ISSN:0065-1419
[Cp] País de publicação:Austria
[La] Idioma:eng
[Ab] Resumo:Neuroendoscopy is now considered to be a minimally invasive surgical approach for expanding lesions bulging into the ventricle, and it is also considered to be a relevant tool for performing biopsy procedures, fenestration of cystic walls, or for performing tumor removal in selected cases. Furthermore, the use of neuroimaging and the accurate follow-up of brain tumor patients have allowed the documentation of tumoral and pseudotumoral cystic areas that cause the obstruction of cerebrospinal fluid (CSF) pathways. Neuroendoscopic procedures enable the fenestration of cystic lesions, in addition to enabling third ventriculostomy or septostomy to restore CSF pathways. We analyze our experience regarding 77 patients affected by brain tumors arising from the wall of the third or lateral ventricle. In all cases hydrocephalus or obstruction of CSF flow was present. With an endoscopic technique, septostomy, cystostomy, endoscopic third ventriculostomy (ETV), and tumor resection were performed to control intracranial hypertension.ETV was performed in 53 patients with noncommunicating hydrocephalus. In 4 patients with low-grade astrocytoma ETV was definitely the only surgical treatment. In 12 cystic tumors, cystostomy and marsupialization into the ventricle solved a relevant mass effect with clinical intracranial hypertension syndrome. In 10 patients, neuroendoscopic relief of CSF pathways was possible by performing septostomy with the implantation of an Ommaya reservoir or one-catheter shunt. In 5 colloid cysts and 2 cystic craniopharyngiomas, removal was possible by restoring CSF flow without other procedures. After intracranial hypertension control, in 13 malignant gliomas and 5 leptomeningeal metastases, the patients' quality of life improved sufficiently to provide for tumor adjuvant therapy.In this series, endoscopy, due to its minimally invasive characteristics and reduced complications, was found to be safe and effective, without any relevant postoperative morbidity, gained by avoiding major surgical approaches.Based on these results and on the increasing number of series described in the literature, we believe that endoscopic techniques should be considered a selected approach for treating CSF obstructions caused by para-intraventricular tumors. The result of using neuroendoscopy is the reconstruction of CSF pathways that bypass the tumor occlusion. This surgical procedure is not only limited to the relief of noncommunicating hydrocephalus, but it is also useful for tumor removal or biopsies and the evacuation of cystic lesions. In patients affected by malignant tumors, neuroendoscopy can be performed to control intracranial hypertension before the patients start adjuvant chemotherapy or radiotherapy.
[Mh] Termos MeSH primário: Neoplasias do Ventrículo Cerebral/cirurgia
Craniofaringioma/cirurgia
Glioma/cirurgia
Hidrocefalia/cirurgia
Neuroendoscopia/métodos
Neoplasias Hipofisárias/cirurgia
Ventriculostomia/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Neoplasias do Ventrículo Cerebral/complicações
Neoplasias do Ventrículo Cerebral/diagnóstico por imagem
Neoplasias do Ventrículo Cerebral/secundário
Criança
Craniofaringioma/complicações
Craniofaringioma/diagnóstico por imagem
Feminino
Glioma/complicações
Glioma/diagnóstico por imagem
Seres Humanos
Hidrocefalia/diagnóstico por imagem
Hidrocefalia/etiologia
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Neoplasias Hipofisárias/complicações
Neoplasias Hipofisárias/diagnóstico por imagem
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170126
[St] Status:MEDLINE
[do] DOI:10.1007/978-3-319-39546-3_14


  9 / 3053 MEDLINE  
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[PMID]:28100864
[Au] Autor:Terasaka S; Kobayashi H
[Ad] Endereço:Department of Neurosurgery, Hokkaido University Graduate School of Medicine.
[Ti] Título:[Pre- and Intra-Operative Supporting Technology for Brain Tumors(3)Surgical Approaches and Strategies for Third Ventricle Tumors].
[So] Source:No Shinkei Geka;45(1):73-90, 2017 Jan.
[Is] ISSN:0301-2603
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Mh] Termos MeSH primário: Neoplasias do Ventrículo Cerebral/cirurgia
Procedimentos Neurocirúrgicos/métodos
Terceiro Ventrículo/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Imagem por Ressonância Magnética
Imagem Multimodal
Procedimentos Neurocirúrgicos/instrumentação
Posicionamento do Paciente
Terceiro Ventrículo/diagnóstico por imagem
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170503
[Lr] Data última revisão:
170503
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170120
[St] Status:MEDLINE
[do] DOI:10.11477/mf.1436203453


  10 / 3053 MEDLINE  
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[PMID]:28084922
[Au] Autor:Cinalli G; Imperato A; Mirone G; Di Martino G; Nicosia G; Ruggiero C; Aliberti F; Spennato P
[Ad] Endereço:Department of Pediatric Neurosurgery, Santobono-Pausilipon Children's Hospital, Naples, Italy.
[Ti] Título:Initial experience with endoscopic ultrasonic aspirator in purely neuroendoscopic removal of intraventricular tumors.
[So] Source:J Neurosurg Pediatr;19(3):325-332, 2017 Mar.
[Is] ISSN:1933-0715
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE Neuroendoscopic removal of intraventricular tumors is difficult and time consuming because of the lack of an effective decompression system that can be used through the working channel of the endoscope. The authors report on the utilization of an endoscopic ultrasonic aspirator in the resection of intraventricular tumors. METHODS Twelve pediatric patients (10 male, 2 female), ages 1-15 years old, underwent surgery via a purely endoscopic approach using a Gaab rigid endoscope and endoscopic ultrasonic aspirator. Two patients presented with intraventricular metastases from high-grade tumors (medulloblastoma, atypical teratoid rhabdoid tumor), 2 with subependymal giant cell astrocytomas (associated with tuberous sclerosis), 2 with low-grade intraparaventricular tumors, 4 with suprasellar tumors (2 craniopharyngiomas and 2 optic pathway gliomas), and 2 with pineal tumors (1 immature teratoma, 1 pineal anlage tumor). Hydrocephalus was present in 5 cases. In all patients, the endoscopic trajectory and ventricular access were guided by electromagnetic neuronavigation. Nine patients underwent surgery via a precoronal bur hole while supine. In 2 cases, surgery was performed through a frontal bur hole at the level of the hairline. One patient underwent surgery via a posterior parietal approach to the trigone while in a lateral position. The endoscopic technique consisted of visualization of the tumor, ventricular washing to dilate the ventricles and to control bleeding, obtaining a tumor specimen with biopsy forceps, and ultrasonic aspiration of the tumor. Bleeding was controlled with irrigation, monopolar coagulation, and a thulium laser. RESULTS In 7 cases, the resection was total or near total (more than 90% of lesion removed). In 5 cases, the resection was partial. Histological evaluation of the collected material (withdrawn using biopsy forceps and aspirated with an ultrasonic aspirator) was diagnostic in all cases. The duration of surgery ranged from 30 to 120 minutes. One case was complicated by subdural hygroma requiring a subduro-peritoneal shunt implant. CONCLUSIONS In this preliminary series, endoscopic ultrasonic aspiration proved to be a safe and reliable method for achieving extensive decompression or complete removal in the management of intra- and/or paraventricular lesions in pediatric patients.
[Mh] Termos MeSH primário: Neoplasias do Ventrículo Cerebral/diagnóstico por imagem
Neoplasias do Ventrículo Cerebral/cirurgia
Neuroendoscopia/métodos
Paracentese/métodos
Ultrassonografia de Intervenção/métodos
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Feminino
Seres Humanos
Lactente
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170316
[Lr] Data última revisão:
170316
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170114
[St] Status:MEDLINE
[do] DOI:10.3171/2016.10.PEDS16352



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