الفهرس | Only 14 pages are availabe for public view |
Abstract The third ventricle is located in the center of the head, below the corpus callosum and the body of the lateral ventricle, above the sella turcica, pituitary gland, and midbrain, and between the cerebral hemispheres, the two halves of the thalamus, and the two halves of the hypothalamus. It is intimately related to the circle of Willis and its branches and the great vein of Galen and its tributaries. Accordingly, tumors in the region of the third ventricle are among the most difficult to expose and remove (Rhoton 2004). Tumours of the third ventricle could be classified into anterior and posterior third ventricular tumours: Anterior tumours e.g. colloid cyst, astrocytomas, craniopharyngeoma, meningiomas, metastatic, ependymomas and choroid plexus papilloma. While Posterior third ventricular tumours comprise mainly pineal tumours and germinomas. (Fonseca RB et al, 2012). There are basic approaches to the third ventricle: transcortical, and transcallosal, which are facilitated by endoscopy. Less used, would be the sub-frontal via lamina terminalis access and stereotactic techniques. The endoscopic technique is improving its results and establishing itself as a reliable method of choice for many neurosurgeons, to access the pathologies of the third ventricle with the least complications. (Wolfgang Seeger, 2006). Primary endoscopic approach for solid tumors has got some limitations, thus it should be considered as a treatment option in highly selected patients with strict criteria and disciplined surgical technique to minimize risk and maximize potential for definitive treatment. As for cystic tumors (primarily colloid cysts), although endoscopic resection has become the established current standard, yet some procedure related complications do exist and need further evaluation to improve outcome. (Patra et al 2005). Aim of the work: Discussing third ventricular brain tumours and their neurosurgical management. Introduction of neuroendoscopy as a tool that could be an alternative to conventional surgical intervention will be the core of my work depending on literature review. Advantages of endoscopic management as well as its complications in comparison with conventional surgery will be mentioned in details. |