Endoscopic management of thalamic gliomas.

The management of thalamic gliomas is extremely variable, ranging from radical excision in some cases to more conservative therapy such as a biopsy and radiation. There is a high incidence of associated hydrocephalus. The principles of management are, therefore, histological diagnosis, CSF diversion and adjuvant therapy. Endoscopy appears to offer a new approach to achieve histology and CSF diversion. The various goals achieved with the use of endoscopy in the management of 4 patients with thalamic gliomas are described. With the endoscope we achieved histological diagnoses and CSF diversion was facilitated in all these cases. There were no complications. The advantages of endoscopy in the management of thalamic masses are discussed. Endoscopic intervention appears to offer a modular approach to these lesions.