Indigenous customized sponge shunt for a recurrent brainstem cyst.
BACKGROUND
Various treatment modalities are available for treatment of cystic lesions of the brainstem. However, cyst refilling and recurrences are very common. This article describes a young boy who presented with an intra-axial brainstem cyst following radiation for a pilocytic astrocytoma.


METHODS
The cyst was decompressed surgically once but it soon refilled. The use of a novel customized synthetic sponge acting as a shunt for the treatment of a cystic brainstem lesion is discussed. The sponge was fashioned like a dumbbell and inserted across the fenestration in the cyst wall.


RESULTS
The dumbbell design made it self-retaining. The characteristics of the sponge permitted continuous capillary drainage, with a low risk of occlusion. There was a dramatic decrease in the cyst size on follow-up scans, with resolution of clinical deficits.


CONCLUSIONS
A customized sponge shunt can serve as an easily available and effective internal shunt for intra-axial craniospinal cysts.
Moiyadi
Aliasgar V
AV
Department of Surgical Oncology, Neurosurgical Services, Tata Memorial Hospital, Mumbai, India. aliasgar.moiyadi@gmail.com
Shetty
Prakash M
PM
D000293:Adolescent; D001672:Biocompatible Materials / Q000627:therapeutic use; D001933:Brain Stem / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D020863:Central Nervous System Cysts / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D002557:Cerebrospinal Fluid Shunts / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures / Q000295:instrumentation* / Q000379:methods; D011140:Polyurethanes / Q000627:therapeutic use; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D055502:Secondary Prevention; D015503:Surgical Sponges / Q000592:standards / Q000639:trends*; D016896:Treatment Outcome
D001672:Biocompatible Materials; D011140:Polyurethanes