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Intraventricular Choroid Plexus Cavernoma Resection Using Tubular Retractor System and Exoscope Visualization: A
Boyi Li1, Michael G Kim2, Jose Dominguez2
1Department of Neurosurgery, New York Medical College, Valhalla, New York, USA.
Operative Neurosurgery (Hagerstown, Md.)
|January 14, 2022
Summary
This study presents the first case of a choroid plexus intraventricular cavernous malformation (IVCM) successfully removed using a tubular retractor system. This minimally invasive approach offers safe and effective treatment for rare IVCMs, improving visualization and reducing brain retraction.
Area of Science:
- Neurosurgery
- Neurology
- Vascular Malformations
Background:
- Intraventricular cavernous malformations (IVCMs) are rare CNS vascular malformations, comprising 2.5% to 10.8% of intracranial cavernous malformations.
- IVCMs can cause significant complications including hemorrhage, hydrocephalus, and mass effect, posing diagnostic challenges.
- Diagnosis can be difficult as IVCMs may mimic other intraventricular lesions.
Observation:
- A 71-year-old male presented with imbalance after a fall, revealing a 2-cm enhancing mass in the right lateral ventricle via MRI.
- The lesion was associated with intraventricular hemorrhage, adjacent edema, leptomeningeal enhancement, and a concurrent pituitary lesion.
Findings:
- Surgical resection of the choroid plexus IVCM was performed via a right parietal craniotomy using a transsulcal approach with a tubular retractor system.
- Complete tumor removal was confirmed postoperatively, with the patient experiencing an uneventful recovery.
Implications:
- This case highlights the first reported use of a tubular retractor system for choroid plexus IVCM resection.
- The tubular retractor system provides a safe and effective minimally invasive surgical option, minimizing brain retraction and enhancing visualization of deep-seated lesions.
