Aqueductal glioma surgery via a telovelar approach using sodium fluorescein in a 6-year-old pediatric patient.

Abstract

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.