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Transcallosal Colloid Cyst Resection: Lateral Position

August 17, 2016

Transcript

Here's a video describing resection, of a colloid cyst via their trans closer approach with the patient in the lateral position. This is a 52 year old male who presented with progressive, worsening headaches, as well as some mild confusion. MRI evaluation revealed mild to moderate hydrocephalus, associated with the colloid cyst. The left frame and appear to be more expanded, and therefore a left-sided transmandibular approach was selected for exposure, of the cyst. The lateral position has number of advantages. First of all, gravity retraction is exploited and interim is with dissection, is more readily, performed with the interhemispheric structures in the horizontal position. Neuro navigation was utilized in this case, to map and plan an incision, a vertical one, crossing the midline. The incision was just about anterior to the Cornell suture. The craniotomy unroof ed, the superior sagittal sinus. The interhemispheric corridor was entered. The pericallosal sole arteries, were separated and the Corpus callosum exposed. Again neuro navigation guides, the small callosotomy. One has to make sure that the correct ventricle, has been entered. The septum Pellucidum is herniating, because of, hydrocephalus within the contralateral ventricle, fenestration of the septum pellucidum, readily reduces it away from our operative corridor. Here's the left foramen, can see the cord plexus, septal vein these are some of the landmarks that can be utilized to make sure that, the correct foramen is targeted. Here's the wall of the cyst. The cyst is entered and decompressed. That's a very important maneuver to allow mobilization of the cyst. In this case , the cyst was readily mobilized, within the foramen and extracted. There were not significant Adhesions. Hemostasis was secured. no residual, cyst wall, on the roof of the third ventricle is apparent. In the posterior aspect of the foramen, is where the cyst is mostly adherent to. An external ventricular drain was placed, for one or two days after surgery. Here's the closure. And a three months MRI evaluation revealed the resolution of the hydrocephalus and gross total, removal of the colloid cyst, without any complicating feature. Thank you.

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