Surgical Resection of Ependymoma in the 4th Ventricle
Ependymoma Surgery in the 4th ventricle requires microsurgical and endoscopic techniques for safe and maximal tumor resection.
In this video, Dr. Daniel Kelly, Director of the Pacific Brain Tumor Center, Providence Saint John's Health Center demonstrates the surgical removal of an ependymoma within the 4th ventricle using microsurgical techniques and endoscopic visualization.
Ependymomas are glial neoplasms (gliomas) that can arise in any of the brain's fluid-filled chambers (cerebral ventricles). When they arise in the 4th ventricle, they can cause headaches, slurred speech, swallowing difficulties, coordination and balance difficulties as well as hydrocephalus. In this case, the patient was a young man who developed progressive and severe headaches leading to an MRI and the diagnosis of a 4th ventricular tumor. The MRI clearly showed the tumor causing pressure on the brainstem and cerebellum. The surgical video demonstrates how the tumor was approached through a suboccipital craniotomy, the route into the 4th ventricle, microscopic tumor removal and finally the use of endoscopy to confirm maximal tumor resection. Fortunately in our patient, over 97% of the tumor was able to be removed and it was low grade ependymomas (WHO Grade II). Given the small remaining tumor remnant left adherent to the brainstem, he was treated with stereotactic radiation shortly after surgery. Now more than 5 years after surgery, he is doing well with no evidence of tumor regrowth.
At the Pacific Brain Tumor Center we have one of the world's largest experiences treating all types of brain and skull base tumors using minimally invasive keyhole and endoscopic approaches.
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