Endoscopic Endonasal Excision of a Ventral Exophytic Brainstem Glioma: A Technical Case Report

Ventral midbrain glioma is an extremely rare lesion in adults. The endoscopic endonasal approach is potentially a better alternative to transcranial approach for this challenging lesion and has not been described in the literature.A 22-yr-old woman previously operated through an interhemispheric approach for ventral midbrain glioma with extension in the suprasellar cistern presented with severe headache and diplopia. Imaging revealed an increase in size of the residual lesion. The tumor was resected by using an extended endonasal approach. The patient had improvement in her diplopia with no endocrine complication.This case demonstrates the surgical technique of endoscopic endonasal resection of a ventral midbrain glioma.