ArticleAsian journal of neurosurgery2025
Endoscopic Third Ventriculostomy in a Child with Tectal Glioma and Extremely Diminished Prepontine Interval.
Article in Asian journal of neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Diminished prepontine interval is a challenging intraoperative finding that creates an additional risk while doing an endoscopic third ventriculostomy (ETV) due to the proximity of the basilar artery to the ventriculostomy site. It is not a contraindication for the procedure especially in patients with thinned floors through which the vascular structures can be easily visualized and it was not proven to be a risk factor for failure of the procedure. Old children with hydrocephalus secondary to tectal glioma have a high chance of successful ETV, thus avoiding shunt dependency. A 12-year-old male patient presented with headache and grade III papilledema, magnetic resonance imaging brain revealed tectal glioma and triventricular hydrocephalus. He underwent a successful ETV despite a challenging intraoperative, extremely diminished prepontine interval. At 1-year follow-up, brain imaging showed a complete resolution of hydrocephalus and stationary course for the tectal glioma. The present case highlights that diminished prepontine interval is not a contraindication for doing ETV unless safety cannot be guaranteed, and it was not proven to be a risk factor for ETV failure. Creating a stoma on the dorsum sellae after palpating the bone or just behind it using blunt fenestration is a safe way especially in the presence of a thinned third ventricle floor with clearly visualized vascular structures.
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