Acta Neurochir (2017) 159:1597–1601 DOI 10.1007/s00701-017-3257-2 HOW I DO IT - NEUROSURGICAL TECHNIQUES Tractography guides the approach for resection of thalamopeduncular tumors 1,2 1,2 Ryan Foley & Frederick Boop Received: 5 January 2017 /Accepted: 19 June 2017 /Published online: 3 July 2017 Springer-Verlag GmbH Austria 2017 . . Abstract Keywords Thalamopeduncular tumor Brain stem tumor . . . Background Thalamopeduncular tumors arise at the junction Pilocytic astrocytoma Pediatric tumor Tractography of the inferior thalamus and cerebral peduncle, and present Transchoroidal resection with a common clinical syndrome of progressive spastic hemiparesis. Method Formal preoperative magnetic resonance imaging Relevant surgical anatomy (MRI) and diffusion tensor imaging (DTI) were performed. Postoperative MRI was obtained to evaluate the extent of The thalamopeduncular syndrome is a common clinical pre- tumor resection. A prospective analysis of clinical outcomes sentation of progressive spastic hemiparesis exhibited by chil- was then conducted by the senior author. dren harboring a tumor of the cerebral peduncle just under- Conclusions Preoperative tractography is a useful adjunct to neath the thalamus (Fig. 1). They typically present in the first 2 surgical planning in tumors that displace motor pathways. decades of life and are pilocytic astrocytomas. As these Gross total resection of pilocytic
Acta Neurochirurgica – Springer Journals
Published: Jul 3, 2017
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