{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T16:06:11Z","timestamp":1749917171376},"reference-count":40,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>We describe the technical report and results of the first image-guided, linear accelerator, frameless radiosurgical third ventriculostomy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods: <\/jats:title>\n<jats:p>We report a 20 years old man, with diplopia, balance disturbances, and limitation for gaze supraversion. Magnetic resonance imaging resonance imaging of the brain and cranial computed tomography showed showed a left thalamic-midbrain lesion that caused partial compression of the Silvio aqueduct and mild ventricular dilatation. The biopsy revealed the diagnosis of pleomorphic xanthoastrocytoma. Before radical treatment of the tumor with fractionated stereotactic radiotherapy, the patient underwent to frameless radiosurgical third ventriculostomy, on the TrueBeam STX\u00ae platform with the ExacTrac localization system. The target used was the one defined on the floor of the third ventricle, at the midpoint between the mammillary bodies and the infundibular recess. The prescription dose was 120 Gy, given using a monoisocentric technique of multiple noncoplanar circular arches. The geometric arrangement of the plan consisted of 15 arches, with a 4 mm cone, distributed over a 110\u00b0 table.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results: <\/jats:title>\n<jats:p>There was symptomatic and image improvement two days after radiosurgery. On CT, a reduction in ventricular dilation was observed with a reduction in the Evans index from 0.39 (initial CT) to 0.29 (CT at 15 days). In 3.0T magnetic resonance image at 3 months, we showed the third ventriculostomy. There have been no treatment failures or complications.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>It is possible to effectively perform the frameless radiosurgical third ventriculostomy without associated morbidity in the short term.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_247_2020","type":"journal-article","created":{"date-parts":[[2020,11,18]],"date-time":"2020-11-18T11:37:29Z","timestamp":1605699449000},"page":"398","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Frameless radiosurgical third ventriculostomy: Technical report"],"prefix":"10.25259","volume":"11","author":[{"given":"Guillermo Axayacalt","family":"Gutierrez-Aceves","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Rodriguez-Camacho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel Angel","family":"Celis-Lopez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Moreno-Jimenez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose Alfredo","family":"Herrera-Gonzalez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2020,11,18]]},"reference":[{"key":"10.25259\/SNI_247_2020\/ref-1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3171\/jns.2007.106.1.1","article-title":"Stereotactic radiosurgery-an organized neurosurgery-sanctioned definition","volume":"106","author":"Barnett","year":"2007","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_247_2020\/ref-2","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.wneu.2010.07.001","article-title":"Frameless image-guided radiosurgery for initial treatment of typical trigeminal neuralgia","volume":"74","author":"Chen","year":"2010","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_247_2020\/ref-3","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/s10143-005-0376-7","article-title":"Linac radiosurgery as a tool in neurosurgery","volume":"28","author":"Deinsberger","year":"2005","journal-title":"Neurosurg Rev"},{"key":"10.25259\/SNI_247_2020\/ref-4","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1007\/s00381-010-1263-2","article-title":"Endoscopic third ventriculostomy versus ventriculoperitoneal shunt in the treatment of obstructive hydrocephalus due to posterior fossa tumors in children","volume":"27","author":"El-Ghandour","year":"2011","journal-title":"Childs Nerv Syst"},{"key":"10.25259\/SNI_247_2020\/ref-5","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1159\/000099731","article-title":"Lesion size following Gamma Knife treatment for functional disorders","volume":"66","author":"Friehs","year":"1996","journal-title":"Stereotact Funct Neurosurg"},{"key":"10.25259\/SNI_247_2020\/ref-6","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.surneu.2003.08.033","article-title":"Linear accelerator thalamotomy","volume":"62","author":"Frighetto","year":"2004","journal-title":"Surg Neurol"},{"key":"10.25259\/SNI_247_2020\/ref-7","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/j.ijrobp.2011.05.048","article-title":"Clinical evaluation of a robotic 6-degree of freedom treatment couch for frameless radiosurgery","volume":"83","author":"Gevaert","year":"2012","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.25259\/SNI_247_2020\/ref-8","doi-asserted-by":"crossref","first-page":"S14","DOI":"10.21037\/cco.2017.06.07","article-title":"Stereotactic radiosurgery of the brain: A review of common indications","volume":"6","author":"Gilbo","year":"2017","journal-title":"Chin Clin Oncol"},{"key":"10.25259\/SNI_247_2020\/ref-9","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1055\/s-2003-37957","article-title":"The role of third ventriculostomy in the management of obstructive hydrocephalus","volume":"46","author":"Grunert","year":"2003","journal-title":"Minim Invasive Neurosurg"},{"key":"10.25259\/SNI_247_2020\/ref-10","doi-asserted-by":"crossref","first-page":"121","DOI":"10.4103\/2152-7806.102338","article-title":"Radiosurgical third ventriculostomy: Technical note","volume":"3","author":"Gutierrez-Aceves","year":"2012","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_247_2020\/ref-11","doi-asserted-by":"crossref","first-page":"2066","DOI":"10.1118\/1.2241001","article-title":"Accuracy assessment of a non-invasive image guided system for intra-cranial linac based stereotactic radiosurgery","volume":"33","author":"Hacker","year":"2006","journal-title":"Med Phys"},{"key":"10.25259\/SNI_247_2020\/ref-12","first-page":"1","article-title":"International Commission on Radiation Units and Measurements. 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