Endoscopic Management of Thalamic Gliomas

Abstract

The management of thalamic gliomas is extremely variable, ranging from radical excision in some cases to more conservative therapy such as a biopsy and radiation. There is a high incidence of associated hydrocephalus. The principles of management are, therefore, histological diagnosis, CSF diversion and adjuvant therapy. Endoscopy appears to offer a new approach to achieve histology and CSF diversion. The various goals achieved with the use of endoscopy in the management of 4 patients with thalamic gliomas are described. With the endoscope we achieved histological diagnoses and CSF diversion was facilitated in all these cases. There were no complications. The advantages of endoscopy in the management of thalamic masses are discussed. Endoscopic intervention appears to offer a modular approach to these lesions.

Key words

Glioma - thalamic - endoscope - CSF diversion

References

• 1 Beks JWF, Bouma OJ, Journee HL. Tumors of the thalamic region. A retrospective study of 27 cases.  Acta Neurochir (Wien). 1987;  85 125-127
• 2 Kelly PJ, Kall BA, Goerss SJ. Special stereotactic techniques: stereotactic laser resection of deep-seated tumors. In: Heilbrun MP (ed). Concepts in Neurosurgery - Stereotactic Neurosurgery. Vol: 2 Philadephia, Williams & Wilkins 1988: 239
• 3 Prakash B. Surgical approach to large thalamic gliomas.  Acta Neurochirurgica. 1985;  74 100-104
• 4 Goel A. Pre-operative shunts in thalamic tumors.  Neurol India. 2000;  48 347-350
• 5 MacArthur DC, Buxton N, Punt J, Vloeberghs, Robertson IJA. The role of neuroendoscopy in the management of brain tumors.  Br J Neurosurg. 2002;  16 465-470
• 6 Gabb MR, Schroeder HWS. Neuroendoscopic approach to intraventricular lesions.  Neurosurgery Focus. 1999;  6 , Article 5
• 7 Yurtseven T, Ersahin Y, Demirtas E, Mutluer S. Neuroendoscopic biopsy for intraventricular tumors.  Minim Invas Neurosurg. 2003;  46 293-299

Correspondence