A Novel Bilateral Approach for Suprasellar Arachnoid Cysts: A Case Report.
The endoscopic method is used to treat suprasellar arachnoid cysts (SACs) but it is sometimes difficult to make sufficiently sized fenestrations. Creating a larger fenestration on the cyst wall is preferable to prevent closure of the stoma. In this paper, we report a novel endoscopic approach for SAC treatment in which we use bilateral burr holes to achieve a more extensive cyst fenestration. A 7-year-old girl was referred to our hospital because of incidentally detected hydrocephalus by computed tomography scans. Physical examination did not show any signs of intracranial hypertension, but a digital impression of her skull on X-ray implied chronic intracranial hypertension. Magnetic resonance imaging (MRI) revealed enlargement of both lateral ventricles and a cystic mass occupying the third ventricle. We performed cyst wall fenestration using a bilateral approach in which we created two burr holes to introduce a flexible endoscope and a rigid endoscope. The cyst wall was held by forceps with the flexible endoscope, and resection of the cyst wall was achieved by using a pair of scissors with the rigid endoscope. There were no postoperative complications, and MRI performed 1 year after treatment showed disappearance of the superior part of the cyst wall.
Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
Shingo
S
Fujio
Jacob
J
Bunyamin
Hirofumi
H
Hirano
Tatsuki
T
Oyoshi
Yuko
Y
Sadamura
Manoj
M
Bohara
Kazunori
K
Arita
D016080:Arachnoid Cysts / Q000000981:diagnostic imaging / Q000601:surgery*; D002648:Child; D004724:Endoscopy / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology; D008279:Magnetic Resonance Imaging; D019635:Neurosurgical Procedures / Q000379:methods*; D020542:Third Ventricle / Q000473:pathology; D014057:Tomography, X-Ray Computed