Minimally invasive techniques: full endoscopic inferior parietal lobule approach for an endoventricular removal of a left trigone meningioma grade I.

Intraventricular meningiomas are rare tumors, mainly localized in the lateral ventricle trigone. Several microscopic surgical approaches have been proposed according to the location of the tumors in the atrium. The authors present the case of a 68-year-old woman who had an increscent medically resistant headache with a left trigone meningioma. In the video, they demonstrate the four-hands surgical technique through a minimally invasive fully endoscopic retractor-less transcortical approach. They also discuss the background of these tumors and the technical nuances of the procedure, including the differences between an endoscopic surgical and a microsurgical one. The video can be found here: https://stream.cadmore.media/r10.3171/2023.1.FOCVID2296.

Carpal tunnel syndrome caused by the entrapment of a bifid Lanz IIIA Type anatomical variant of median nerve: A case report and systematic literature review.

BACKGROUND: Carpal tunnel syndrome (CTS) is the most common entrapment peripheral neuropathy. Median nerve may present several anatomical variations such as a high division or bifid median nerve (BMN). A thorough knowledge of the normal anatomy and variations of the median nerve at the wrist are fundamental to reduce complications during carpal tunnel release. CASE DESCRIPTION: A 63-year-old man with CTS underwent preoperative ultrasound that showed the entrapment of the median nerve and disclosed a BMN Lanz IIIA Type anatomical variation at the carpal tunnel. During the surgery, the anatomical variant of a BMN at the wrist has been visualized. Both nervous rami entirely occupied the carpal canal and this may have predisposed to the development of the entrapment syndrome. Nor persistent median artery, or other associated abnormalities, have been identified. At the 6 months follow-up control, the patient referred a good surgical recovery with complete resolution of the preoperative symptoms of the median nerve entrapment. CONCLUSION: A rare case of Lanz IIIA BMN Type at the wrist has been encountered in a patient with a CTS and a systematic review and practical considerations have been presented with the aim of raising awareness to the neurosurgical community of a such rare variant that could be encountered during carpal tunnel release procedures. CTS may be caused by the entrapment of a BMN Lanz IIIA Type anatomical variant of median nerve. Preoperative US would help to identify such patients to reduce risk of iatrogenic injuries.