Abstract
Background When symptomatic, quadrigeminal cistern arachnoid cysts (QCACs), comprising 5 to
10% of all intracranial arachnoid cysts, are treated by open fenestration or shunt
placement and in recent decades by endoscopic techniques. We introduce a novel endoscopic
technique that may be used for surgery of QCACs.
Patient A 52-year-old woman with a known history of QCAC (treated twice previously by open
procedures) presented with symptoms, signs, and radiologic indicators of shunt malfunction
and cyst recollection. Because of high-riding pineal gland and distortion of anatomy
that resulted from the last surgeries, and loss of a suitable visual angle, a satisfactory
ventriculocystostomy was not possible through the third ventricle. Therefore, the
cyst was approached by entering the trigonal region of the lateral ventricle, allowing
to perform ventriculocystostomy.
Results and Conclusion Postoperative imaging and follow-up visits proved this approach to be efficacious.
This report, for the first time, introduces the so-called transtrigone lateral ventricle
cystostomy as an alternative for cases of QCAC for which the ventriculocystostomy
via the third ventricle is not suitable.
Keywords
arachnoid cyst - cyst fenestration - endoscopy - hydrocephalus
