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Related Experiment Video

Updated: Oct 4, 2025

Author Spotlight: A Single-Entry Point Endoscopic Intraventricular Approach for Third Ventriculostomy and Pineal Biopsy
03:13

Author Spotlight: A Single-Entry Point Endoscopic Intraventricular Approach for Third Ventriculostomy and Pineal Biopsy

Published on: June 28, 2024

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Multiple lessons learned from a single case: Complications from pineal germinoma management.

Sultan Al-Saiari1, Faisal A Asiri1, Ahmed A Farag1

  • 1Department of Neurosurgery King Abdullah Medical City, Makkah, Western Saudi Arabia.

Surgical Neurology International
|February 7, 2022
PubMed
Summary

A pineal germinoma case highlights unexpected intraventricular hemorrhage (IVH) post-external ventricular drain removal, leading to vasospasm. The tumor also showed spontaneous regression, emphasizing careful monitoring and prompt vasospasm management.

Keywords:
Endoscopic third ventriculostomyExternal ventricular drainGerminomaHydrocephalusIntraventricular hemorrhageVasospasm

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Area of Science:

  • Neuro-oncology
  • Neurosurgery
  • Neuroradiology

Background:

  • Pineal germinomas are rare, often treated with endoscopic third ventriculostomy (ETV) and biopsy.
  • Cerebral vasospasm is well-studied in aneurysmal subarachnoid hemorrhage but less so in intraventricular hemorrhage (IVH).

Observation:

  • An 18-year-old male developed severe vasospasm and IVH after EVD removal post-ETV and biopsy for a pineal germinoma.
  • Follow-up MRI revealed significant regression of the germinoma without adjuvant therapy.

Findings:

  • Postoperative IVH following EVD removal can precipitate severe clinical vasospasm.
  • Spontaneous regression of pineal germinoma is possible, though uncommon.

Implications:

  • Maintain a high suspicion for vasospasm in patients with IVH after ETV, enabling timely intervention for better outcomes.
  • Obtain recent preoperative MRI and use postoperative CT sparingly to avoid radiation-induced tumor changes and accurately assess tumor status.