15 Intraventricular Approaches

  • Rafael Uribe-Cardenas
  • Mark M. SouweidaneEmail author


Intraventricular neuroendoscopy has become an important tool in the armamentarium of the neurosurgeon dealing with complex lesions within the ventricular system. Endoscopic approaches are useful for obtaining tissue samples for histopathological analysis, diverting CSF in complex hydrocephalus, and for the complete excision of ventricular tumors. Knowledge of intraventricular anatomy is crucial to minimize complications and plan surgical approaches effectively. The use of ancillary technology like stereotactic frameless neuronavigation can increase accuracy and minimize complications. Although larger ventricles are easier to navigate, normal or small ventricles are not a contraindication for an endoscopic approach.


Neuroendoscopy Minimally invasive Cerebral Lateral ventricle Third ventricle Intraventricular tumor Neuronavigation ETV Hydrocephalus 


  1. 1.
    Yaşargil MG, Abdulrauf SI. Surgery of intraventricular tumors. Neurosurgery. 2008;62(6 Suppl 3):1029–40. –discussion1040–1.PubMedGoogle Scholar
  2. 2.
    Anderson RC, Ghatan S, Feldstein NA. Surgical approaches to tumors of the lateral ventricle. Neurosurg Clin N Am. 2003;14(4):509–25.CrossRefGoogle Scholar
  3. 3.
    Lozier AP, Bruce JN. Surgical approaches to posterior third ventricular tumors. Neurosurg Clin N Am. 2003;14(4):527–45.CrossRefGoogle Scholar
  4. 4.
    Decq P, Schroeder HWS, Fritsch M, Cappabianca P. A history of ventricular neuroendoscopy. WNEU. Elsevier Inc. 2013;79(S):S14.e1–6.Google Scholar
  5. 5.
    Abbott R. History of neuroendoscopy. Neurosurg Clin N Am. 2004;15(1):1–7.CrossRefGoogle Scholar
  6. 6.
    Schmitt PJ, Jane JA. A lesson in history: the evolution of endoscopic third ventriculostomy. Neurosurg Focus. 2012;33(2):E11.CrossRefGoogle Scholar
  7. 7.
    Cappabianca P, Cinalli G, Gangemi M, Brunori A, Cavallo LM, de Divitiis E, et al. Application of neuroendoscopy to intraventricular lesions. Neurosurgery. 2008;62(Suppl 2(Supplement 2)):575–97. –discussion:597–8.CrossRefGoogle Scholar
  8. 8.
    Souweidane MM. Endoscopic management of pediatric brain tumors. Neurosurg Focus. 2005;18(6A):E1.CrossRefGoogle Scholar
  9. 9.
    Souweidane MM, Luther N. Endoscopic resection of solid intraventricular brain tumors. J Neurosurg. 2006;105(2):271–8.CrossRefGoogle Scholar
  10. 10.
    Badie B, Brooks N, Souweidane MM. Endoscopic and minimally invasive microsurgical approaches for treating brain tumor patients. J Neuro-Oncol. 2004;69(1-3):209–19.CrossRefGoogle Scholar
  11. 11.
    Luther N, Edgar MA, Dunkel IJ, Souweidane MM. Correlation of endoscopic biopsy with tumor marker status in primary intracranial germ cell tumors. J Neuro-Oncol. 2006;79(1):45–50.CrossRefGoogle Scholar
  12. 12.
    Santos MM, Souweidane MM. Purely endoscopic resection of a choroid plexus papilloma of the third ventricle: case report. J Neurosurg Pediatr. 2015;16(1):54–7.CrossRefGoogle Scholar
  13. 13.
    Margetis K, Souweidane MM. Endoscopic treatment of intraventricular cystic tumors. WNEU. Elsevier Inc. 2013;79(S):S19.e1–S19.e11.Google Scholar
  14. 14.
    Margetis K, Christos PJ, Souweidane M. Endoscopic resection of incidental colloid cysts. J Neurosurg. 2014;120(6):1259–67.CrossRefGoogle Scholar
  15. 15.
    Cinalli G. Endoscopic third ventriculostomy for obstructive hydrocephalus. Neurosurg Rev. 2004;28:1–34.Google Scholar
  16. 16.
    Lewis AI, Keiper GL, Crone KR. Endoscopic treatment of loculated hydrocephalus. J Neurosurg. 1995;82(5):780–5.CrossRefGoogle Scholar
  17. 17.
    Fritsch MJ, Mehdorn M. Endoscopic intraventricular surgery for treatment of hydrocephalus and loculated CSF space in children less than one year of age. Pediatr Neurosurg. 2002;36(4):183–8.CrossRefGoogle Scholar
  18. 18.
    Nowosławska E, Polis L, Kaniewska D, Mikołajczyk W, Krawczyk J, Szymanski W, et al. Effectiveness of neuroendoscopic procedures in the treatment of complex compartmentalized hydrocephalus in children. Childs Nerv Syst. 2003;19(9):659–65.CrossRefGoogle Scholar
  19. 19.
    Greenfield JP, Souweidane MM. Endoscopic management of intracranial cysts. Neurosurg Focus. 2005;19(6):E7.CrossRefGoogle Scholar
  20. 20.
    Lekovic GP, Gonzalez LF, Feiz-Erfan I, Rekate HL. Endoscopic resection of hypothalamic hamartoma using a novel variable aspiration tissue resector. Neurosurgery. 2006;58(1 Suppl):ONS166–9. –discussionONS166–9.PubMedGoogle Scholar
  21. 21.
    Morgenstern PF, Osbun N, Schwartz TH, Greenfield JP, Tsiouris AJ, Souweidane MM. Pineal region tumors: an optimal approach for simultaneous endoscopic third ventriculostomy and biopsy. Neurosurg Focus. 2011;30(4):E3.CrossRefGoogle Scholar
  22. 22.
    Rhoton AL. The lateral and third ventricles. Neurosurgery. 2002;51(4 Suppl):S207–71.PubMedGoogle Scholar
  23. 23.
    Kucukyuruk B, Richardson RM, Wen HT, Fernandez-Miranda JC, Rhoton AL. Microsurgical anatomy of the temporal lobe and its implications on temporal lobe epilepsy surgery. Epilepsy Res Treat. 2012;2012(5):1–17.Google Scholar
  24. 24.
    Souweidane MM. Endoscopic surgery for Intraventricular brain tumors in patients without hydrocephalus. Operat Neurosurg. 2005;57:312–8.CrossRefGoogle Scholar
  25. 25.
    Yamamoto M, Oka K, Takasugi S, Hachisuka S, Miyake E, Tomonaga M. Flexible neuroendoscopy for percutaneous treatment of Intraventricular lesions in the absence of hydrocephalus. © Georg Thieme Verlag Stuttgart, New York. Minim Invasive Neurosurg. 1997;40(4):139–43.CrossRefGoogle Scholar

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© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.New York Presbyterian, Department of Neurological SurgeryWeill-Cornell Medical CollegeNew YorkUSA
  2. 2.Department of Neurological SurgeryNew York-Presbyterian/Weill Cornell Medical Center, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical CollegeNew YorkUSA

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