title: Endoscopic fenestrations for suprasellar arachnoid cysts.
abstract: OBJECTIVE
  The endoscopic treatment of a suprasellar arachnoid cyst (SAC) consists mainly of ventriculocystostomy (VC) and ventriculocystocisternostomy (VCC). However, the most appropriate treatment for these cysts has not been fully determined yet. The authors report on the effectiveness of endoscopic VC for SACs communicating with the basal cisterns, which is demonstrated by preoperative CT cisternography.
  
  
  METHODS
  The authors retrospectively analyzed the surgical results of patients with an SAC treated using endoscopic fenestration. The patient charts were reviewed for demographic data, clinical presentations, surgical therapies, and clinical outcomes.
  
  
  RESULTS
  Six consecutive patients with SAC were surgically treated using endoscopic fenestration (VC or VCC) between March 2004 and February 2011. The mean age was 18.5 months (range 5 days to 37 months). Five patients were previously untreated, and 1 patient had previously undergone ventriculoperitoneal shunt placement. Five patients underwent preoperative CT cisternography, and communication between the SAC and the basal cisterns was demonstrated in 3 patients, very slight communication in 1, and no communication in 1. Four patients, including the 3 with communication between the SAC and basal cisterns, underwent VC. Two patients with very slight or no communication underwent VCC. In all patients the SAC decreased in size and hydrocephalus improved postoperatively. Five patients (3 treated with VC and 2 with VCC [83%]) have been stable without reoperation (mean follow-up 32.7 months). All 3 patients with an SAC communicating with the basal cisterns have been stable without reoperation following VC.
  
  
  CONCLUSIONS
  Preoperative cisternography may be useful for selecting the optimal endoscopic treatment method for SAC. If an SAC communicates with the basal cisterns, a VC could be an effective, safe, and simpler treatment option.
authors: Division of Neurosurgery, National Center for Child Health and Development, Tokyo, Japan. hideki_o@d5.dion.ne.jp
authors: Hideki
authors: H
authors: Ogiwara
authors: Nobuhito
authors: N
authors: Morota
authors: Masahiro
authors: M
authors: Joko
authors: Kengo
authors: K
authors: Hirota
mesh_terms: D016080:Arachnoid Cysts / Q000601:surgery*; D020863:Central Nervous System Cysts / Q000601:surgery*; D002675:Child, Preschool; D002946:Cisterna Magna / Q000000981:diagnostic imaging; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D011011:Pneumoencephalography; D012189:Retrospective Studies; D020542:Third Ventricle / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014696:Ventriculostomy