Cavalheiro Sergio, Quiróz José Antonio Rangel, Dastoli Patricia Alessandra, Kim Isaque Hyung Tong, Suzuki Fernando Seiji, da Costa Marcos Devanir Silva
Department of Neurology and Neurosurgery, University Federal of São Paulo, São Paulo, Brazil.
Fellows of Pediatric Neurosurgery, Department of Neurology and Neurosurgery, University Federal of São Paulo, Rua Dos Otonis, Vila Clementino, 431, 2 Nd Floor, São Paulo, SP, 04025 - 001, Brazil.
Childs Nerv Syst. 2025 May 11;41(1):177. doi: 10.1007/s00381-025-06827-z.
Periaqueductal gliomas are a subset of brainstem gliomas that typically present symptoms related to hydrocephalus due to obstruction of cerebrospinal fluid pathways. These tumors are generally low grade and have a favorable prognosis. Management often focuses on resolving hydrocephalus, with surgical intervention considered when symptoms or radiological images worsen. Sodium fluorescein is a fluorescent dye used in brain tumor surgeries to enhance visualization, allowing surgeons to distinguish between tumor tissue and normal brain tissue more effectively. This technique improves the precision and safety of tumor resection. We present the case of a 6-year-old patient in whom we performed the telovelar approach to resect periaqueductal gliomas via sodium fluorescein (2.5 mg/kg) for adequate resection, with excellent postoperative results. Ethics committee approval was not required to perform the surgical procedure on the patient. The patient's parents provided informed consent for the surgery and gave verbal consent for the publication of their video surgery.
导水管周围胶质瘤是脑干胶质瘤的一个子集，由于脑脊液通路受阻，通常会出现与脑积水相关的症状。这些肿瘤一般为低级别，预后良好。治疗通常侧重于解决脑积水问题，当症状或影像学检查结果恶化时考虑进行手术干预。荧光素钠是一种用于脑肿瘤手术的荧光染料，可增强可视化效果，使外科医生能够更有效地区分肿瘤组织和正常脑组织。该技术提高了肿瘤切除的精准度和安全性。我们报告了一例6岁患者的病例，我们通过荧光素钠（2.5mg/kg）采用经小脑幕下入路切除导水管周围胶质瘤，以实现充分切除，术后效果良好。对该患者进行手术无需伦理委员会批准。患者父母为手术提供了知情同意，并口头同意公布其手术视频。
