title: Role of endoscopy in recalcitrant intraventricular tuberculoma-innovative novel treatment adjunct.
abstract: BACKGROUND
  Intraventricular tuberculomas are rare entities. To the best of our knowledge, only 14 cases have been reported in English literature. Medical management of cerebral tuberculomas is well accepted. Intraventricular tuberculomas may be recalcitrant for unclear reasons. An effective management protocol for this entity is unclear. To the best of our knowledge, the definitive indication, timing, and possible role of surgery in these lesions have not been discussed in literature.
  
  
  METHODS
  A 27-year-old nursing professional who was undergoing treatment for miliary tuberculosis at another center presented to us in 2008 with right hemiparesis, deteriorating vision, and progressive decline in consciousness. In addition to antituberculous therapy (ATT), she underwent multiple CSF diversion procedures for the obstructive hydrocephalus secondary to a recalcitrant third ventricular tuberculoma. Finally, she underwent endoscopic decompression of the lesion with a very good clinical response at 1-year follow-up.
  
  
  CONCLUSIONS
  We discuss a patient with recalcitrant intraventricular tuberculoma managed using neuroendoscopy along with the standard antituberculous therapy. We also discuss in detail the technique we utilized for endoscopic management of this lesion.
  
  
  CONCLUSIONS
  Being a rare entity, a consensus for management of these lesions is not possible, but we have demonstrated that neuroendoscopic management of these rare entities is an option giving the advantage of definitive diagnosis when required, hastening the resolution, and clearing the CSF pathway.
authors.affiliation: a Division of Pediatric Neurosurgery, Department of Neurosurgery , Amrita Institute of Medical Sciences and Research Centre , Kochi , India.
authors.forename: Suhas
authors.initials: S
authors.lastname: Udayakumaran
authors.affiliation: a Division of Pediatric Neurosurgery, Department of Neurosurgery , Amrita Institute of Medical Sciences and Research Centre , Kochi , India.
authors.forename: Prakash
authors.initials: P
authors.lastname: Nair
authors.affiliation: b Department of Microbiology , Amrita Institute of Medical Sciences and Research Centre , Kochi , India.
authors.forename: Anil
authors.initials: A
authors.lastname: Kumar
authors.affiliation: a Division of Pediatric Neurosurgery, Department of Neurosurgery , Amrita Institute of Medical Sciences and Research Centre , Kochi , India.
authors.forename: Dilip
authors.initials: D
authors.lastname: Panikar
keywords: intraventricular tuberculomas; neuroendoscopy; recalcitrant tuberculomas