The endoscopic intraventricular management of pineal cysts: a minimally invasive modus operandi

The management of pineal cysts is still debatable, especially for asymptomatic incidental ones. For symptomatic cysts associated with hydrocephalus, the surgical management is mandatory and may include either classical microsurgical approaches to the pineal region or endoscopic trans-ventricular approaches in a minimally invasive philosophy. The authors expose a stepwise technique to treat a pineal cyst associated with an obstructive hydrocephalus in one procedure gathering a third ventriculostomy followed by an intraventricular marsupialisation of the pineal cyst. This endoscopic approach allows the treatment of the hydrocephalus and the pineal cyst in one short minimally invasive procedure.