1. Combined microsurgical and endoscopic removal of large brain lesions in children: a report of two cases
Domagoj Jugović
Andrej Porčnik
Marjan Koršič
University Medical center Ljubljana, Slovenia

2. 1st Congress of Southeast European Neurosurgical Society - SEENS
Introduction
Recent developments in neuroendoscopy have greatly impacted the diagnosis and treatment of brain lesions.
Treating children in early childhood presents a challange in neurosurgery.
We presented two cases in which neuroendoscopy was a helpful additional tool in adjunct to microsurgery.
1st Congress of Southeast European Neurosurgical Society - SEENS

3. 1st Congress of Southeast European Neurosurgical Society - SEENS
First Case report
A cyst in the cisterna ambiens was detected with ultrasonography at the 29th week of gestation in a male fetus.
Magnetic resonance imaging showed a large cyst causing non-communicating hydrocephalus.
1st Congress of Southeast European Neurosurgical Society - SEENS

4. 1st Congress of Southeast European Neurosurgical Society - SEENS
First Case report
A planed caesarean section was performed at the 35th week of gestation.
A combined endoscopic and microsurgical approach was performed 2 days after birth with good outcome.
1st Congress of Southeast European Neurosurgical Society - SEENS

5. 1st Congress of Southeast European Neurosurgical Society - SEENS
First Case report
Before the operation
The neurological development was normal and no neurological deficits were present.
MRI 2 years after the operation showed a marked expansion of the brain parenchyma with no hydrocephalus.
After the operation
1st Congress of Southeast European Neurosurgical Society - SEENS

6. 1st Congress of Southeast European Neurosurgical Society - SEENS
Second Case report
A 13-month old female child presented with a signs and symptoms of increased intracranial pressure. Magnetic resonance imaging showed a large intra-ventricular solid tumor in the left lateral ventricle.
1st Congress of Southeast European Neurosurgical Society - SEENS

7. 1st Congress of Southeast European Neurosurgical Society - SEENS
Second Case report
A complete microsurgical removal was achieved with the help of neuroendoscopy. A pathohistological examination revealed a choroid plexus papilloma. No neurological deficits were present after surgery.
MRI after the operation showed no residual tumor mass.
1st Congress of Southeast European Neurosurgical Society - SEENS

8. 1st Congress of Southeast European Neurosurgical Society - SEENS
Conclusion
In microsurgical treatment of pediatric brain tumors a neuroendoscopy can provide an additional view of tight anatomic spaces frequently present in infant patients.
With less brain retraction, smaller operative exposures and better visualisation offered, neuroendoscopy may reduce operative morbidity.
Domagoj Jugović
Andrej Porčnik
Marjan Koršič
University Medical center Ljubljana, Slovenia
1st Congress of Southeast European Neurosurgical Society - SEENS