Abstract
Background
Surgical resection is the cornerstone of treatment for low-grade tumors, albeit total excision is beneficial. As the thalamus is surrounded by vital neurovascular system, lesions here present a surgical challenge.
Method
This article aims to demonstrate the trans-temporal, trans-choroidal fissure approach’s effective surgical therapy on patients with thalamic lesions. With this approach, we were able to remove the tumor completely in three patients and almost completely in six more. Here we discuss a few technical details and potential hazards of the procedure with an operative video.
Conclusion
This approach provides excellent access to the deep areas of brain.
This is a preview of subscription content, log in via an institution to check access.
Availability of data and material
Not applicable.
Code availability
Not applicable.
References
Broadway SJ, Ogg RJ, Scoggins MA, Sanford R, Patay Z, Boop FA (2011) Surgical management of tumors producing the thalamopeduncular syndrome of childhood. J Neurosurg Pediatr 7(6):589–595. https://doi.org/10.3171/2011.4.PEDS119
Celtikci E, Celtikci P, Fernandes-Cabral DT, Ucar M, Fernandez-Miranda JC, Borcek AO (2017) High-definition fiber tractography in evaluation and surgical planning of thalamopeduncular pilocytic astrocytomas in pediatric population: case series and review of literature. World Neurosurg 98:463–469. https://doi.org/10.1016/j.wneu.2016.11.061
Hamlat A, Morandi X, Riffaud L et al (2008) Transtemporal-transchoroidal approach and its transamygdala extension to the posterior chiasmatic cistern and diencephalo-mesencephalic lesions. Acta Neurochir (Wien) 150(4):317–328. https://doi.org/10.1007/s00701-007-1460-2
Ikeda K, Shoin K, Mohri M, Kijima T, Someya S, Yamashita J (2002) Surgical indications and microsurgical anatomy of the transchoroidal fissure approach for lesions in and around the ambient cistern. Neurosurgery 50(5):1114–1120. https://doi.org/10.1097/00006123-200205000-00030
Puget S, Crimmins DW, Garnett MR et al (2007) Thalamic tumors in children: a reappraisal. J Neurosurg 106(5 Suppl):354–362. https://doi.org/10.3171/ped.2007.106.5.354
Siwanuwatn R, Deshmukh P, Zabramski JM, Preul MC, Spetzler RF (2005) Microsurgical anatomy and quantitative analysis of the transtemporal-transchoroidal fissure approach to the ambient cistern. Neurosurgery 57(4 Suppl):228–235. https://doi.org/10.1227/01.neu.0000176407.35946.88
Ulm AJ, Tanriover N, Kawashima M, Campero A, Bova FJ, Rhoton A Jr (2004) Microsurgical approaches to the perimesencephalic cisterns and related segments of the posterior cerebral artery: comparison using a novel application of image guidance. Neurosurgery 54(6):1313–1328. https://doi.org/10.1227/01.neu.0000126129.68707.e7
Wen HT, Rhoton AL Jr, de Oliveira E et al (1999) Microsurgical anatomy of the temporal lobe: part 1: mesial temporal lobe anatomy and its vascular relationships as applied to amygdalohippocampectomy. Neurosurgery 45(3):549–592. https://doi.org/10.1097/00006123-199909000-00028
Yasargil MG, Kasdaglis K, Jain KK, Weber HP (1976) Anatomical observations of the subarachnoid cisterns of the brain during surgery. J Neurosurg 44(3):298–302. https://doi.org/10.3171/jns.1976.44.3.0298
Funding
All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
Author information
Authors and Affiliations
Contributions
The contribution of all the authors have been listed at the end of title page.
Corresponding author
Ethics declarations
Ethics approval
NA.
Consent to participate
Waived off, due to the retrospective nature of the study.
Consent for publication
The consent for publication of the images and operative video has been obtained from the patient.
Conflicts of interest/Competing interests
The authors report no conflict of interest or financial disclosure concerning the materials or methods used in this study or the findings specified in this paper.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Supplementary file1 (MP4 248818 KB)
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Kanjilal, S., Bhaisora, K.S., Maurya, V.P. et al. Trans-temporal trans-choroidal resection of thalamic and thalamopeduncular tumors: how I do it. Acta Neurochir 166, 281 (2024). https://doi.org/10.1007/s00701-024-06175-y
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s00701-024-06175-y