Obstructive hydrocephalus from pineal region tumor

• Outcomes and Surgical Approaches for Pineal Region Tumors in Adults: A Retrospective Study of a Single-Center Over 12 Years
• Coexistence of Charles Bonnet Syndrome and occipital epilepsy: A diagnostic challenge
• Treatment of a Large Hemorrhagic Midbrain Cavernoma Within the Silvian Aqueduct in a Five-Year-Old Girl-A Case Report
• Pineal parenchymal tumor of intermediate differentiation: Case series and literature review: Is it time for a consensus?
• Subtotal Resection with Proton-Beam Radiotherapy for Treatment of Pineal Parenchymal Tumor of Intermediate Differentiation in a Pediatric Patient
• Recurrent pineal tumor in a young adult male: Challenges in diagnosis and multimodal treatment management
• Papillary Tumor of the Pineal Region Identified by DNA Methylation Leads to the Incidental Finding of Germline Mutation PTEN G132D Associated with PTEN Hamartoma Tumor Syndrome: A Case Report and Systematic Review
• Treatments for obstructive hydrocephalus secondary to malignant midline intracranial tumors during the perioperative period - a retrospective study of 372 pediatric patients from a single institution

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 tumors ¹⁾

Direct removal of pineal lesions with the opening of the posterior third ventricle could represent effective and reliable management of the associated obstructive hydrocephalus ²⁾.

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 ³⁾