Abstract
Introduction
Neuroendoscopic biopsy represents the procedure of choice for pure intraventricular lesions. Instead, in case of deep-seated paraventricular tumors, with intact ependyma, the advantage of neuroendoscopy over stereotactic biopsy is not so evident, because the lesion is not under direct vision; the tissue sample may be limited to more superficial ependymal layer, and bleeding may obscurate vision. Also, stereotactic biopsy may reserve additional problems for these lesions: inaccuracy caused by leak of cerebrospinal fluid and increased risk of severe hemorrhage due to damage of the ependymal vessels.
Case reports
We report two cases of young children affected by thalamic tumors that were biopsied using a modification of a recently proposed technique: endoscopic visual control, neuronavigated needle biopsy.
Conclusion
This technique may combine the accuracy of a stereotactic needle biopsy with the advantage of visual control on site of ependymal puncture and possibility of immediate bleeding control.
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References
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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standard
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Case 1: Pre-operative images and intraoperative video (MP4 55692 kb)
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Spennato, P., Ruggiero, C., Mirone, G. et al. Endoscopic needle biopsy of thalamic tumors: technical note. Childs Nerv Syst 36, 2835–2840 (2020). https://doi.org/10.1007/s00381-020-04676-6
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DOI: https://doi.org/10.1007/s00381-020-04676-6