Related Experiment Video
Updated: Aug 7, 2026
Endoscopic Third Ventriculostomy and Pineal Biopsy from a Single Entry Point
Published on: June 28, 2024
Endoscope-assisted infratentorial-supracerebellar approach to the third ventricle: an anatomical study
Andrea Cardia1, Manuela Caroli, Mauro Pluderi
1Department of Neurosurgery, Galeazzi Hospital, Milan, Italy.
Object:
The authors studied the microsurgical anatomy and endoscopic features of the pineal region and third ventricle to describe a combined microsurgical-endoscopic infratentorial-supracerebellar approach to the posterior third ventricle. Such an approach exposes the pineal gland and its complex neurovascular structures so that the third ventricle can be reached through a minimally invasive parapineal incision.
Methods:
The approach was studied in 10 adult cadaveric heads, six fresh and four formalin fixed, by using an operative microscope with a magnification level of 6 to 40 and the assistance of an endoscope. The endoscope-assisted infratentorial-supracerebellar approach affords a complete view of the third ventricle from a posterior perspective. The third ventricle is entered through a parapineal incision using the natural space between the internal cerebral vein and the vein of Rosenthal located above the superior colliculi.
Conclusions:
The infratentorial-supracerebellar approach to the third ventricle follows a natural corridor and requires minimal retraction and resection of critical neural structures. With the use of the endoscope, an unsurpassed view into the third ventricle from a posterior perspective is obtained.
