Intraventricular craniopharyngioma

• Revisiting the combined approach of Yasargil for microsurgical removal of intra-extraventricular and pure intraventricular craniopharyngiomas
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• Predictors of mortality at 3 months in patients with skull base tumor resections in a low-income setting
• Analysis of the different pathways of ectopic recurrence of craniopharyngioma in pediatric patients: presentation of cases and review of the literature
• Ensuring Neurosurgical Equity: Setup for Safe Ventricular Endoscopy and Predictors of Clinical Outcome in a Resource-Limited Health Care System
• Endoscopic Supraorbital Translaminar Approach
• Fully Endoscopic Minimally Invasive Trans-Eyebrow Supraorbital Translaminar Approach to Third Ventricle Craniopharyngiomas: Technical Nuances and Stepwise Illustrative Description
• Epidermoid cyst of central nervous system: A case series and review of literature

Intraventricular craniopharyngiomas account for 0.5–11% of all craniopharyngiomas ^{1) 2)}

These tumors show an intact third ventricle floor, a suprasellar cistern, a normal pituitary stalk, and an absence of sellar abnormalities ³⁾.

Intraventricular craniopharyngiomas are difficult to remove.

The two main surgical approaches for these lesions are the translamina terminalis approach and the transventricular approaches. The translamina terminalis approach using subfrontal, pterional, or basal interhemispheric approaches has been used to treat suprasellar or intraventricular craniopharyngiomas ^{4) 5) 6)}.

Although this approach is easy for accessing tumors in the inferior part of the third ventricle, it is difficult to remove large lesions ⁷⁾.

The transventricular approach through a transcortical or transcallosal approach allows access to the third ventricle with transforaminal, subchoroidal, or transfornician approaches. The usefulness of these approaches have been reported for intraventricular tumor removal ^{8) 9) 10) 11)} but there is a risk of injuries to the surrounding neuronal or vascular structures, such as the body of the fornix.

We combined an interhemispheric transcallosal approach with a flexible endoscope (videoscope) for successful tumor removal.

A 52-year-old male complained of general fatigue and memory disturbance. Magnetic resonance imaging revealed a well-enhanced third ventricle mass with dilatation of lateral ventricles. During removal with the interhemispheric transcallosal approach, a videoscope that was inserted into the left lateral ventricle revealed the interface of the tumor and the ventricular wall. The tumor was pushed to the right using forceps and removed totally through the right foramen of Monro without any fornix injury.

This procedure is a safe option for removing third ventricular tumors especially in the case with hydrocephalus ¹²⁾.