Neuroendoscopic stent procedure in obstructive hydrocephalus due to both foramina of monro occluding craniopharyngioma: technical note.
BACKGROUND
The development of various neuroendoscopic surgical instruments has offered more options for endoscopic procedures in the treatment of intraventricular tumors. Not only tumor biopsy or tumor resection but also restoration of an obstructed cerebral spinal fluid (CSF) pathway can be performed using the same approach.


METHODS
A 76-year-old woman with a cardiac pacemaker for an underlying heart disease was diagnosed with obstructive hydrocephalus because of a third ventricular tumor 8 years ago. The patient had been treated with ventriculo-peritoneal shunt placement. At admission she presented with a subcutaneous infection of the shunt catheter and an abdominal mass of unknown etiology. Neuroendoscopic stenting between lateral and third ventricle was performed to restore the obstructed CSF pathway, and the infected shunt system was removed in the same setting.


RESULTS
The postoperative course was uneventful. Contrast ventriculography demonstrated a restored CSF pathway between the lateral and third ventricle. Histologic examination of the intraventricular tumor revealed a craniopharyngioma, and the abdominal mass was diagnosed as a gastrointestinal adenocarcinoma.


CONCLUSIONS
The neuroendoscopic foraminoplasty technique should be considered as an alternative treatment for patients who present with an obstructive hydrocephalus caused by a tumor that occludes both foramina of Monro when shunt placement or endoscopic third ventriculostomy is not feasible.
Department of Neurosurgery, Philipps University, Marburg, Germany.
Wuttipong
W
Tirakotai
Thomas
T
Riegel
Dirk Michael
DM
Schulte
Helmut
H
Bertalanffy
Dieter
D
Hellwig
D000230:Adenocarcinoma / Q000175:diagnosis; D000368:Aged; D002552:Cerebral Ventricles; D014695:Cerebral Ventriculography; D002557:Cerebrospinal Fluid Shunts; D003397:Craniopharyngioma / Q000150:complications* / Q000175:diagnosis; D020878:Device Removal; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis; D006801:Humans; D006849:Hydrocephalus / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D016609:Neoplasms, Second Primary / Q000175:diagnosis; D044583:Neuroendoscopy; D010166:Palliative Care; D010911:Pituitary Neoplasms / Q000150:complications* / Q000175:diagnosis; D015607:Stents; D020542:Third Ventricle; D014057:Tomography, X-Ray Computed