Cranial Remodeling Surgery in Patient with Large Arachnoid Cyst

Introduction Intracranial arachnoid cysts are congenital malformations presenting with collection of cerebrospinal fluid formed by the splitting or duplication of the arachnoid membrane. When located in the middle cranial fossa, bone modeling process can result in thinning and bulging of the adjacent bone.

Aim Aim of this study is to present cranial remodeling surgical technique used for repairing calvarial deformation in patient with arachnoid cyst.

Materials and Methods We present a case of an 8-year-old boy with large disfiguring Galassi type 3 middle cranial fossa arachnoid cyst displacing not only the temporal lobe but also the frontal and parietal lobes. Multiple horizontal barrel staves osteotomies with additional bone adjustments were performed to reshape frontal and temporal bone. Remodeling surgery was followed by implantation of ventriculoperitoneal shunt with programmable valve. Postoperative course was uneventful.

Results Correction of frontotemporal bone deformity was achieved with good symmetry and permanent result.

Conclusion This surgical technique can be used as a safe and efficient tool for cranial remodeling and brain decompression in patients with extensive intracranial arachnoid cysts.