====== Obstructive hydrocephalus from pineal region tumor ======

{{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/10CQYG4wH40NtEUaOoifMZ10OrueFSu-92-IlOmJkex6A64kAT/?limit=15&utm_campaign=pubmed-2&fc=20231107063207}}
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===== Treatment =====

Pineal region tumors resection usually should be performed before shunting, unless there is an acute [[obstructive hydrocephalus]]. The posterior [[third ventricle]] should be opened after [[tumor resection]]. Intraoperative [[third ventriculostomy]] and ventriculocisternal shunt are reliable ways to manage hydrocephalus secondary to [[pineal region tumor]]s
((Zhang Z, Wang H, Cheng H, Fan Y, Hang C, Sun K, Zhu L. Management of hydrocephalus secondary to pineal region tumors. Clin Neurol Neurosurg. 2013 Sep;115(9):1809-13. doi: 10.1016/j.clineuro.2013.05.009. Epub 2013 Jun 3. PMID: 23743211.))
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Direct removal of pineal lesions with the opening of the posterior third ventricle could represent effective and reliable management of the associated obstructive hydrocephalus
((Choque-Velasquez J, Resendiz-Nieves J, Colasanti R, Hernesniemi J. Management of Obstructive Hydrocephalus Associated with Pineal Region Cysts and Tumors and Its Implication in Long-Term Outcome. World Neurosurg. 2021 May;149:e913-e923. doi: 10.1016/j.wneu.2021.01.078. Epub 2021 Jan 28. PMID: 33516866.)).
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Biportal endoscopic approach enables better visual control of both procedures. Furthermore, it allows the surgeon to safely pass the [[ventriculoscope]] via the [[foramen of monro]], even if it is narrow. Moreover, during endoscopic [[tumor]] [[biopsy]] and [[third ventriculostomy]], the intracranial pressure can be smoothly managed using the outlet tubes accessible. This treatment may be an alternative to traditional uniportal endoscopic operations in certain patients
((Al-Saiari S, Al Orabi K, Abdoh MG, Basurrah AA, Albalawi SF, Farag AA. Simultaneous biportal endoscopic management of pineal region tumors in patients with obstructive hydrocephalus: technical notes. Chin Neurosurg J. 2023 Jan 10;9(1):1. doi: 10.1186/s41016-022-00313-0. PMID: 36624512; PMCID: PMC9830701.))