PMC4275816_01
(a-c) T1, T2 and diffusion weighted images of the fourth ventricular tumour (preoperative).
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Diffusion weighted series on Magnetic resonance imaging (MRI) showed increased attenuation (Fig. 1) of the lesion suggestive of an intra-ventricular epidermoid.
The Destaudeau endoscopic spine system (Storz).
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Unlike endoscopic systems designed for intra-ventricular use, it has no inbuilt irrigation system, however we had connected an irrigation line to the suction apparatus via a 3 way valve to allow alternative use of irrigation and suction as and when needed (Fig. 2).
(A) Intraoperative endoscopic images of the intra ventricular lesion. (B) Partly occluded foramen of monro.
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The foramen of monro, bilaterally, appeared to be partly occluded by the adherent capsule and adhesions (Fig. 3B).
(a-c) T1, T2 and diffusion weighted images of the fourth ventricular tumour (post operative).
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The patient was ambulated after 24 h, following a post-operative scan (Fig. 4), which showed gross total excision of the tumour. MRI scan revealed dilatation of the lateral ventricles (Fig. 4), hence the patient underwent ventriculo-peritoneal shunt, placed through the initial cortical incision.