Endoscopic Biopsy and Resection of Intraventricular Tumors

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What are intraventricular tumors? 

Ventricles are cavities within the brain that are filled with a clear, protective liquid called cerebrospinal fluid. When brain tumors occur within these cavities, they are known as intraventricular tumors, of which there are several types: 

• Astrocytomas: tumors that originate from supporting cells in the brain
• Meningiomas: tumors that form in the brain’s protective covering
• Ependymomas: tumors that form within the lining of the ventricles
• Colloid cysts & Craniopharyngiomas: tumors that are formed from developmental cells

What are the symptoms of an intraventricular tumor? 

Early symptoms include headaches, nausea, vomiting, vision changes, and cognitive difficulties. As many of these symptoms are prevalent across a variety of illnesses and conditions, it is important to seek medical attention early if you experience several of these symptoms together. 

Because of their location, these tumors often block the flow of cerebrospinal fluid, causing a build-up known as obstructive hydrocephalus. In hydrocephalus, the additional fluid increases pressure on surrounding brain tissue and causes a variety of symptoms depending on location that over time become life-threatening:

• Headache
• Nausea
• Mental status deterioration
• Sight disruption
• Seizures
• Weakness, tingling, numbness in limbs
• Difficulty speaking
• Mood changes
• Memory loss 
• Eventually, death

What is an endoscopic biopsy of the brain? 

To help determine the best course of treatment for an intraventricular tumor, a neurosurgeon would begin by taking a biopsy, a small sample of tissue, from the tumor using a technique called neuroendoscopy. This is a technique in which the neurosurgeon uses a long, flexible, lighted tube with a high-resolution camera called an endoscope. The endoscope is inserted through the nasal cavity, making it a minimally invasive method to examine the brain.

Specialized tools are then inserted through the tube, which allow the surgeon to take tissue samples from or around the ventricles for testing. This is called an endoscopic biopsy. 

What is the difference between a biopsy and a resection? 

A biopsy is useful for diagnosis, while a resection is used for treatment. During a biopsy, a small tissue sample, or samples, will be collected to examine and diagnose, while a resection is a surgery used to remove a large portion – or all – of a tumor. An endoscopic resection would be a recommended course of a treatment if the biopsy of an intraventricular tumor came back as cancerous. 

What is neuroendoscopy for an intraventricular brain tumor? 

Neuroendoscopy is a minimally invasive endoscopic surgery that allows a surgeon to diagnose and treat intraventricular brain tumors. The procedure involves using a tool called an endoscope, which is a long tube that can reach the brain and allows the surgeon to see the affected area. The surgeon then works through the endoscope to extract and remove the tumor through the nasal passageway. This is called an endoscopic excision.

Neuroendoscopy is typically more successful for smaller cyst-like tumors. Larger, solid tumors typically require more invasive, technically challenging, traditional forms of surgery like a craniotomy, which involves an incision in the scalp to remove a section of the skull to reach the tumor. However, when these larger, solid tumors are difficult to reach with a craniotomy, endoscopic surgery may be recommended.

What is recovery from a neuroendoscopy like? 

A neuroendoscopy to perform endoscopic resection offers several benefits when compared to more conventional surgical approaches. The patient experiences faster recovery time, a reduced risk of complications, and minimal scarring. Typically, the patient will remain in the hospital for monitoring 1-3 days following the procedure, and will usually have a CT scan or MRI to check for early complications. Some sensitivity around the nose and head may be experienced, although pain is usually minimal.