Minimally invasive computer-assisted stereotactic fenestration of an aqueductal cyst: case report.
BACKGROUND
Current advances in frame modeling and computer software allow stereotactic procedures to be performed with great accuracy and minimal risk of neural tissue or vascular injury.


METHODS
In this report we associate a previously described minimally invasive stereotactic technique with state-of-the-art 3D computer guidance technology to successfully treat a 55-year-old patient with an arachnoidal cyst obstructing the aqueduct of Sylvius. We provide detailed technical information and discuss how this technique deals with previous limitations for stereotactic manipulation of the aqueductal region. We further discuss current advances in neuroendoscopy for treating obstructive hydrocephalus and make comparisons with our proposed technique.


CONCLUSIONS
We advocate that this technique is not only capable of treating this pathology but it also has the advantages to enable reestablishment of physiological CSF flow thus preventing future brainstem compression by cyst enlargement.
Fonoff
E T
ET
Division of Functional Neurosurgery, Department and Institute of Psychiatry, University of Sao Paulo Medical School, Brazil. fonoff et@usp.br
Gentil
A F
AF
Padilha
P M
PM
Teixeira
M J
MJ
D016080:Arachnoid Cysts / Q000175:diagnosis / Q000601:surgery*; D002535:Cerebral Aqueduct / Q000473:pathology / Q000601:surgery*; D003287:Contrast Media / Q000008:administration & dosage; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000601:surgery*; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007479:Iopamidol; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009460:Neurologic Examination; D038361:Neuronavigation / Q000379:methods*; D012984:Software; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D007479:Iopamidol