title: Pediatric intraventricular arachnoid cysts in the body of lateral ventricle: surgical outcome and its embryologic background.
abstract: OBJECTIVE
  The aim of this study is for the surgical treatment and outcome of the endoscopic fenestration of the arachnoid cyst located in the ventricular body to trigone in the pediatric population. Special concern was paid for the developmental origin of the intraventricular cysts estimated from the postoperative follow-up neuroimagings.
  
  
  METHODS
  Between July 2002 and June 2015, we performed endoscopic and partly CT/MRI navigated fenestrations of intraventricular arachnoid cysts located at the body to trigone of the lateral ventricle in ten pediatric patients aged 2 months to 5 years. Based on the long axis of the cyst, we have opted for two surgical approaches: anterior approach via burr hole at Kocher's point and posterior approach via burr hole at the posterior occipital region. Fenestration was performed based on the intraoperative findings, either ventriculocystostomy, ventriculocystoventriculostomy, or ventriculocystocisternostomy.
  
  
  RESULTS
  Intraventricular arachnoid cysts located in the body-trigone region showed a favorable outcome after endoscopic fenestration. All of the cysts shrank postoperatively. Follow-up neuroimagings taken between 6 and 126 months after surgery strongly suggested its relationship with the midline cisterns. Of our ten cases, eight were suggestive for originating from the velum interpositum cistern while two seemed to root from the quadrigeminal cistern.
  
  
  CONCLUSIONS
  In the present study, we found that endoscopic fenestration of intraventricular arachnoid cysts in the body to trigone is a safe procedure with a satisfactory outcome. In our limited experience, there are two anatomic backgrounds; velum interpositum cistern and quadrigeminal cistern. Differentiation can be possible by neuroimagings, especially those obtained after surgery.
authors: Division of Neurosurgery, Vivantes Klinikum im Friedrichshain, Landsberger Allee 49, 10249, Berlin, Germany. bettina.knie@vivantes.de.|Division of Neurosurgery, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. bettina.knie@vivantes.de.
authors: Bettina
authors: http://orcid.org/0000-0001-6809-278X
authors: B
authors: Knie
authors: Division of Neurosurgery, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors: Nobuhito
authors: N
authors: Morota
authors: Division of Neurosurgery, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors: Satoshi
authors: S
authors: Ihara
authors: Division of Neurosurgery, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors: Goichiro
authors: G
authors: Tamura
authors: Division of Neurosurgery, National Center for Child Health and Development, Tokyo, Japan.
authors: Hideki
authors: H
authors: Ogiwara
mesh_terms: D016080:Arachnoid Cysts / Q000473:pathology / Q000601:surgery*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D020547:Lateral Ventricles / Q000473:pathology / Q000601:surgery*; D008297:Male; D044583:Neuroendoscopy / Q000379:methods; D014696:Ventriculostomy / Q000379:methods
keywords: Fenestration; Neuroendoscopy; Quadrigeminal cistern; Velum interpositum cistern