The concept of "Four Walls, Two Poles" in the lesions of the thalamus and ganglion regions: case report and literature review

BMC Surg. 2021 Jan 22;21(1):55. doi: 10.1186/s12893-021-01059-9.

Abstract

Background: There are few articles about the surgical techniques of thalamic glioma and the lesions in the basal ganglia area. According to three existing cases and the literature review (Twelve articles were summarized which mainly described the surgical techniques), we discuss the surgical characteristics of lesions of the thalamus and basal ganglia area and summarize the relevant surgical skills.

Case presentation: Of the three cases, two were thalamic gliomas and one was brain abscess in basal ganglia. According to the three-dimensional concept of the "Four Walls, Two Poles", lesions of the thalamus and basal ganglia were surgically removed, and the operative effect was analysed by relevant surgical techniques. Surgical resection of the lesions of the thalamus and basal ganglia area according to the three-dimensional concept of the "Four Walls, Two Poles" has achieved good surgical results. Relevant surgical techniques, such as the use of retractors, the use of aspirators, the choice of surgical approaches, and the haemostasis strategy, also played an important role in the operation process.

Conclusions: In the presented three cases the three-dimensional concept of the "Four Walls, Two Poles" allowed for safe surgical resection of lesions of the thalamus and basal ganglia.

Keywords: Four walls two poles; Microsurgical techniques; Thalamic glioma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Basal Ganglia Diseases / diagnostic imaging
  • Basal Ganglia Diseases / surgery*
  • Basal Ganglia* / diagnostic imaging
  • Basal Ganglia* / surgery
  • Brain Abscess / diagnostic imaging
  • Brain Abscess / surgery*
  • Clinical Competence
  • Glioma / diagnostic imaging
  • Glioma / surgery*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Neurosurgical Procedures* / methods
  • Neurosurgical Procedures* / standards
  • Thalamus* / diagnostic imaging
  • Thalamus* / surgery
  • Tomography, X-Ray Computed