This is an enhanced MRI of a tumour called a craniopharyngioma. It is a tumour more commonly found in children. The best treatment is controversial, but most believe radical surgical removal is the only chance of cure.

Previously, tumours such as this craniopharyngioma, required very large incisions and skull openings in order for the tumour to be removed. Most tumours in this area can be removed just as easily through an eyebrow incision and a very small craniotomy. This is an example of "minimally invasive neurosurgery". Endoscopic guidance is essential.

The incision can be extended laterally but is usually confined to the eyebrow only.

The skin incision tries to preserve the sensory nerves to the forehead.

The bony landmarks must be identified before taking out the window of bone.

The orbital rim can be preserved or taken.

An excellent view of the anatomy can be achieved through this limited exposure.

The goal of surgery is total removal of tumour.

The closure is equally important as the opening.

The cosmetic result is very pleasing and is barely noticeable after 3 months.

This is an MRI of a colloid cyst. This tumour is rare and grows from the third ventricle where if often obstructs the normal flow of spinal fluid. This can result in headache, memory disturbance and even sudden death. Previously, patients undergoing surgery for this particular tumour required a very extensive operation, that sometimes meant splitting the 2 halves of the brain, taking hours and needing 5 to 10 days of recovery, sometimes experiencing memory problems from the surgery, or terrible seizures.

Using minimally invasive endoscopic techniques, these tumours can be removed through a burr hole, the operation taking only 20 minutes in some cases, requiring only 24 to 48 hours recovery and with fewer side effects. Of course, complications can occur even with these techniques, but they appear to be less frequent and less severe.

Once again, endoscopy is an essential tool in these minimally invasive operations.