Endoscopic treatment of quadrigeminal cistern arachnoid cysts.
Five patients with arachnoid cysts of the quadrigeminal cistern treated by endoscopic fenestration are reported and another eleven well-documented cases from the literature are reviewed. Among the five personal cases four were children and one was adult; the cyst fenestration was performed from the lateral ventricle in three cases and from the third ventricle in two. In four patients the endoscopic treatment resulted in clinical remission, whereas a two-month-old baby later required a shunt. The lateral ventricle-cystostomy and the third ventricle-cystostomy (according to the cyst extent) are the best endoscopic procedures, whereas the cyst fenestration through a suboccipital supracerebellar approach is no longer used. The rate of cured or improved patients after endoscopic surgery (14/16 or 87.5%) was rather similar to that of a group of twenty patients treated by traditional surgery (craniotomy and cyst excision and/or shunt) (85%). These data confirm that endoscopic fenestration of quadrigeminal cistern cysts must be performed as the first procedure because it is less invasive and avoids shunt dependency.
Gangemi
M
M
Department of Neurological Sciences, Unit of Neurosurgery, University Federico II, Naples, Italy. mgangemi@unina.it
Maiuri
F
F
Colella
G
G
Magro
F
F
D016080:Arachnoid Cysts / Q000473:pathology / Q000601:surgery*; D002557:Cerebrospinal Fluid Shunts; D002648:Child; D005260:Female; D006801:Humans; D007223:Infant; D020547:Lateral Ventricles / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D044583:Neuroendoscopy / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*; D003336:Tectum Mesencephali / Q000601:surgery; D020542:Third Ventricle / Q000601:surgery; D016896:Treatment Outcome