Transfrontal Transaqueductal, Transtrigonal, and Suboccipital Infratentorial Supracerebellar Endoscopic Fenestration of Posterior Fossa Arachnoid Cysts: Three Surgical Cases

Abstract

Symptomatic intracranial arachnoid cysts are commonly treated using neuroendoscopy. Cysts located within the posterior fossa may present a greater surgical challenge to the neurosurgeon due to the numerous vital neurovascular structures located within this confined space. Adding neuronavigation during endoscopy helps a neurosurgeon to visualize and utilize both anterior and posterior corridors safely to access and manage these lesions. We present three symptomatic posterior fossa arachnoid cysts that were treated successfully using minimally invasive neuronavigation-guided endoscopic neurosurgery utilizing the anterior transfrontal transaqueductal, anterior transfrontal transtrigonal, and posterior suboccipital infratentorial supracerebellar approaches.

Keywords

endoscopy - arachnoid cysts - posterior fossa - transtrigonal - supracerebellar

Publikationsverlauf

Eingereicht: 07. August 2015

Angenommen: 22. Oktober 2015

Publikationsdatum:
11. März 2016 (online)

• References

• 1 Garg K, Tandon V, Sharma S. , et al. Quadrigeminal cistern arachnoid cyst: a series of 18 patients and a review of literature. Br J Neurosurg 2014; 12: 1-7
• 2 Joshi VP, Valsangkar A, Nivargi S, Vora N, Dekhne A, Agrawal A. Giant posterior fossa arachnoid cyst causing tonsillar herniation and cervical syringomyelia. J Craniovertebr Junction Spine 2013; 4 (01) 43-45
• 3 Silav G, Sarı R, Bölükbaşı FH, Altaş M, Işık N, Elmacı İ. Microsurgical fenestration and cystoperitoneal shunt through preauricular subtemporal keyhole craniotomy for the treatment of symptomatic middle fossa arachnoid cysts in children. Childs Nerv Syst 2015; 31 (01) 87-93
• 4 Cinalli G, Spennato P, Columbano L. , et al. Neuroendoscopic treatment of arachnoid cysts of the quadrigeminal cistern: a series of 14 cases. J Neurosurg Pediatr 2010; 6 (05) 489-497
• 5 El-Ghandour NM. Endoscopic treatment of quadrigeminal arachnoid cysts in children. J Neurosurg Pediatr 2013; 12 (05) 521-528
• 6 Gangemi M, Seneca V, Colella G, Cioffi V, Imperato A, Maiuri F. Endoscopy versus microsurgical cyst excision and shunting for treating intracranial arachnoid cysts. J Neurosurg Pediatr 2011; 8 (02) 158-164
• 7 Mahaney KB, Abdulrauf SI. Anatomic relationship of the optic radiations to the atrium of the lateral ventricle: description of a novel entry point to the trigone. Neurosurgery 2008; 63 (04) 195-202 ; discussion 202–203
• 8 Sharifi G, Jahanbakhshi A. Quadrigeminal cistern arachnoid cyst treated by endoscopic ventriculocystostomy through the trigonal region. J Neurol Surg A Cent Eur Neurosurg 2013; 74 (Suppl. 01) e145-e148
• 9 Arakawa Y, Kita D, Ezuka I, Hayashi Y, Hamada J, Hayashi Y. Regression of cerebellar tonsillar descent and hydrocephalus after endoscopic third ventriculostomy in a patient with a quadrigeminal arachnoid cyst. Surg Neurol Int 2013; 4: 142
• 10 Gangemi M, Maiuri F, Colella G, Magro F. Endoscopic treatment of quadrigeminal cistern arachnoid cysts. Minim Invasive Neurosurg 2005; 48 (05) 289-292
• 11 Hayashi N, Endo S, Tsukamoto E, Hohnoki S, Masuoka T, Takaku A. Endoscopic ventriculocystocisternostomy of a quadrigeminal cistern arachnoid cyst. Case report. J Neurosurg 1999; 90 (06) 1125-1128
• 12 Inamasu J, Ohira T, Nakamura Y. , et al. Endoscopic ventriculo-cystomy for non-communicating hydrocephalus secondary to quadrigeminal cistern arachnoid cyst. Acta Neurol Scand 2003; 107 (01) 67-71
• 13 Maher CO, Goumnerova L. The effectiveness of ventriculocystocisternostomy for suprasellar arachnoid cysts. J Neurosurg Pediatr 2011; 7 (01) 64-72