Flexible Neuroendoscopic Diagnosis and Management of Ventricular Tumors: A Retrospective Cohort Study

World Neurosurg. 2018 Oct:118:e707-e712. doi: 10.1016/j.wneu.2018.07.023. Epub 2018 Aug 7.

Abstract

Background: Ventricular tumors (VTs) represent approximately 10% of intracranial lesions and are associated with hydrocephalus in 73.9%-100% of patients. We present our experience using flexible neuroendoscopy as a diagnostic and hydrocephalus-related treatment strategy for paraventricular and intraventricular tumors.

Methods: This retrospective cohort included 27 pediatric and 21 adult patients with paraventricular or intraventricular tumors treated with flexible neuroendoscopy. Terminally ill patients and patients with incomplete data were excluded.

Results: Male and female patients comprised 52% and 48% of the population, respectively. Mean patient age was 20.45 years (±18.65 SD). The most common tumor location was the thalamic and pineal region. Conclusive pathologic diagnosis was obtained in 40 patients (83.3%); the most common type of tumor was astrocytoma. Hydrocephalus was present in 38 (79.1%) patients, who were treated successfully with endoscopic procedures. There were no major complications.

Conclusions: Flexible neuroendoscopy is a strategic tool for diagnosis of VTs, especially in patients with associated hydrocephalus and VTs unreachable by other means. Flexible neuroendoscopy has a high rate of definitive diagnosis with low associated complications. More studies evaluating the long-term efficacy of flexible neuroendoscopy for hydrocephalus associated with VTs are needed.

Keywords: Endoscopic third ventriculostomy; Hydrocephalus; Neuroendoscopy; Ventricular tumors.

MeSH terms

  • Adolescent
  • Adult
  • Cerebral Ventricle Neoplasms / diagnosis*
  • Cerebral Ventricle Neoplasms / surgery*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Hydrocephalus / surgery*
  • Male
  • Neuroendoscopy* / methods
  • Neurosurgical Procedures / methods
  • Retrospective Studies
  • Third Ventricle / surgery*
  • Treatment Outcome
  • Ventriculostomy / methods
  • Young Adult