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Pyogenic ventriculitis is a rare but severe post-neurosurgical complication. The infection is often resistant to antibiotic treatment alone. Continuous intraventricular irrigation has been suggested but the technique is cumbersome, increases the risk for secondary infection, and is inadequate in removing adherent purulence. We used a novel neuroendoscopic approach assisted with a side-cutting aspiration device to treat four cases of post-neurosurgical pyogenic ventriculitis. Ventricular empyema was cleared in all patients and three of the four patients had favorable outcomes., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: Minimally-invasive approaches are attractive alternative to standard craniotomy for large intracranial tumors with potentially lesser morbidity. In this report, we describe a sequential combination of two minimally-invasive surgical techniques to treat a large intracranial tumor., Clinical Presentation: A 49year-old woman presented with a history of breast cancer and large left parietal metastasis with significant perilesional edema. This was initially managed by whole brain radiation therapy and stereotactic radiosurgery. The patient underwent laser ablation of the tumor followed by internal tumor debulking using an exoscopic-assisted tubular retractor system. Post-operative MRI showed gross total coverage of the tumor by laser ablation and alleviation of mass effect. The patient recovered well and discharged on second postoperative day., Conclusion: The minimally-invasive combination of laser ablation followed by internal debulking using a tubular retractor device could be done safely and effectively as a minimally invasive alternative to standard craniotomy for large intracranial tumors., (Copyright © 2016 Elsevier Ltd. All rights reserved.)