Other Tumors of the Third Ventricle and Tumors of the Lateral Ventricles

A variety of tumors and non-neoplastic mass can involve the lateral and third ventricles: many come up from the paraventricular region growing into the ventricle (secondary intraventricular mass), whereas few arise solely within the ventricle (primary intraventricular mass). Many surgical approaches have been described to reach these deep areas. The introduction of the neuroportal system and intraoperative navigation improved the feasibility of transcortical approaches to the supratentorial ventricles and, probably, the long-term outcome. The selection of the most favorable approach to the third ventricle is mainly based on the region of interest. For lesion on the third ventricle roof or foramen of Monro, we adopted the neuroportal-assisted transfrontal transventricular approaches (transforaminal, transchoroidal, transforniceal). Lesion of the floor of the third ventricle can be managed by the antero-lateral basal approaches, mainly the subfrontal translamina terminalis. The combined interhemispheric subcommissural translamina terminalis approach (CISTA) provides an extremely wide operative field for lesions within the antero-superior area of the third ventricle. Extended transsphenoidal surgery can be adopted to address tumors into suprasellar infundibular areas.