Open AccessEndoscopic Management of Arachnoid Cysts
Author(s) -
Flávio Ramalho Romero,
Eduardo de Freitas Bertolini,
Adalberto Sestari,
Sérgio Soares Guerrero,
Ramon Barbalho Guerreiro,
Modesto Cerione Júnior
Publication year - 2018
Publication title -
jornal brasileiro de neurocirurgia
Language(s) - English
Resource type - Journals
eISSN - 2446-6786
pISSN - 0103-5118
DOI - 10.22290/jbnc.v22i4.1039
Subject(s) - arachnoid cyst , medicine , middle cranial fossa , cistern , cyst , endoscope , subarachnoid space , surgery , endoscopy , hydrocephalus , microsurgery , cisterna , etiology , cerebrospinal fluid , radiology , pathology , biology , genetics , archaeology , cell , history , golgi apparatus
Object: Arachnoid cysts are developmental space-occupying lesions filled with CSF-like content and surrounded by a membrane resembling arachnoid mater, with controversial etiology and natural history. Endoscopy has been successfully used for decades to treat a variety of pathologies within thecentral nervous system. Methods: Thirteen patients who underwent endoscopic fenestration for treatment of arachnoid cyst were selected for this study. The surgical indications and techniques were reviewed, and surgical success rates and patient outcomes were assessed. Results: Five patients had middle fossa cysts; 2 a posterior fossa cyst; 3 a quadrigeminal cistern arachnoid cyst and 3 a suprasellar arachnoid cyst. Endoscopic management consisted in a cystoventriculostomy in 8 patients and cystocisternotomy in 5 patients. There was neither mortality nor operative morbidity. Discussion: Arachnoid cysts are a relatively benign pathological entity that can be managed by performing endoscopically guided cyst wall fenestrations into the ventricular system or cerebrospinal fluid containing cisterns. Conclusion: Proper patient selection, preoperative planning of endoscope trajectory, use of frameless navigation, and advances in endoscope lens technology and light intensitycombine to make this a safe procedure with excellent outcomes.