The benefit of image guidance for the contralateral interhemispheric approach to the lateral ventricle.
OBJECTIVE
Recently, neurosurgeons have increasingly faced small intracerebral lesions in asymptomatic or minimally symptomatic patients. Here, we evaluated a series of four patients with nearly asymptomatic intraventricular tumors close to the corpus callosum that had been treated with the aid of an image-guided transcallosal approach.


METHODS
Four consecutive patients suffering from left intra- and paraventricular tumors were operated on via a contralateral interhemispheric transcallosal approach with the aid of neuronavigation. Our image-guided system directed: (1) the skin incision, (2) the interhemispheric dissection, and (3) the incision of the corpus callosum.


RESULTS
Using the image-guided contralateral interhemispheric transcallosal approach to the left ventricle all lesions have been completely resected without the risk of damage to the dominant hemisphere. The callosal incision was kept as limited as possible (1.2-2.1cm) depending on the size of the tumor. No postoperative neurological or neuropsychological deficit was observed in our series.


CONCLUSIONS
Neuronavigation facilitates a safe and targeted contralateral interhemispheric transcallosal approach to the dominant hemisphere's lateral ventricle. Our technique minimizes the risk of damage to the dominant hemisphere and requires only a limited opening of the corpus callosum, which might decrease the risk of neuropsychological morbidity.
Fronda
Chiara
C
Department of Neurosurgery, Philipps University Clinic, Baldingerstrasse, 35033 Marburg, Germany.
Miller
Dorothea
D
Kappus
Christoph
C
Bertalanffy
Helmut
H
Sure
Ulrich
U
D000328:Adult; D001927:Brain Diseases / Q000601:surgery*; D001932:Brain Neoplasms / Q000601:surgery*; D020785:Central Nervous System Vascular Malformations / Q000601:surgery; D002648:Child; D003337:Corpus Callosum / Q000033:anatomy & histology / Q000601:surgery; D004806:Ependymoma / Q000601:surgery; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D020547:Lateral Ventricles / Q000033:anatomy & histology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008579:Meningioma / Q000601:surgery; D019635:Neurosurgical Procedures / Q000379:methods*; D015175:Prolactinoma / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome