Endoscope-controlled Supra-cerebellar Infra-tentorial Approach for Excision Of A Pineal Region Cystic Mass
https://www.neuroendo.net/wp-content/uploads/2019/09/case14_featured_image.jpg 653 653 Samer Elbabaa Samer Elbabaa http://www.neuroendo.net/wp-content/uploads/2019/09/Samer-Elbabaa-photo-96x96.jpgEndoscope-controlled Supra-cerebellar Infra-tentorial Approach for Excision Of A Pineal Region Cystic Mass
Diagnosis: Pineal region cyst
- 14-year old girl
- Chronic headaches followed conservatively for 3 years for a stable pineal cystic mass
- She presented with acute progression of her symptoms
- New MRI showed a slight increase in the size of the mass as well as new proteinous content of the cyst on T2-MRI images
- Different approaches were considered including the classic microsurgical supra-cerebellar infratentorial approach, the parieto-occipital transtentorial approach or posterior transcallosal approach
- Decision was made in favor of an endoscope controlled supra-cerebellar infra-tentorial approach to the pineal region via a small suboccipital craniotomy
- Complete non-eventful excision of the pineal cystic mass was achieved via an endoscope controlled supra-cerebellar infra-tentorial approach
- Symptoms resolved completely
EQUIPMENT USED
- Aesculap skull base endoscopes 0° and 30° lenses
- Neuro-navigation
SURGICAL TIPS
- Semi-sitting position, TEE reduces the risk of air embolism. This allows sagging of the cerebellum with no need for retractors
Pre op
Post op
Operative position
