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Minim Invasive Neurosurg 2005; 48(5): 289-292
DOI: 10.1055/s-2005-915604
Original Article
© Georg Thieme Verlag Stuttgart · New York

Endoscopic Treatment of Quadrigeminal Cistern Arachnoid Cysts

M.  Gangemi1 , F.  Maiuri1 , G.  Colella1 , F.  Magro1
  • 1Department of Neurological Sciences, Unit of Neurosurgery, University “Federico II”, Naples, Italy
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Publication History

Publication Date:
01 December 2005 (online)

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Abstract

Five patients with arachnoid cysts of the quadrigeminal cistern treated by endoscopic fenestration are reported and another eleven well-documented cases from the literature are reviewed. Among the five personal cases four were children and one was adult; the cyst fenestration was performed from the lateral ventricle in three cases and from the third ventricle in two. In four patients the endoscopic treatment resulted in clinical remission, whereas a two-month-old baby later required a shunt. The lateral ventricle-cystostomy and the third ventricle-cystostomy (according to the cyst extent) are the best endoscopic procedures, whereas the cyst fenestration through a suboccipital supracerebellar approach is no longer used. The rate of cured or improved patients after endoscopic surgery (14/16 or 87.5 %) was rather similar to that of a group of twenty patients treated by traditional surgery (craniotomy and cyst excision and/or shunt) (85 %). These data confirm that endoscopic fenestration of quadrigeminal cistern cysts must be performed as the first procedure because it is less invasive and avoids shunt dependency.

Key words

Brain arachnoid cyst - quadrigeminal cistern cyst - endoscopy

References

  • 1 Reganchary S S, Watanabe I. Ultrastructure and pathogenesis of intracranial arachnoid cysts.  J Neuropathol Exp Neurol. 1981;  40 61-83
    CrossrefPubMedSearch in Google Scholar
  • 2 Di Rocco C, Caldarelli M. Supratentorial interhemispheric and pineal region cysts. In: Intracranial Cyst Lesions, Raimondi AG, Choux M, Di Rocco C (eds). New York, Berlin: Springer-Verlag 1993 Chap 11: 153-168
    Search in Google Scholar
  • 3 Ruge J R, Johnson R F, Bauer J. Burr-hole neuroendoscopic fenestration of quadrigeminal cistern arachnoid cyst: technical case report.  Neurosurgery. 1996;  38 830-837
    CrossrefPubMedSearch in Google Scholar
  • 4 Hayashi N, Endo S, Tsukamoto E. et al . Endoscopic ventriculocysternostomy of a quadrigeminal cistern arachnoid cyst: case report.  J Neurosurg. 1999;  90 1125-1128
    Search in Google Scholar
  • 5 Choi J U, Kim D S, Huh R. Endoscopic approach to arachnoid cysts.  Childs Nerv Syst. 1999;  15 56-68
    CrossrefPubMedSearch in Google Scholar
  • 6 Kirillos R W, Javadpur M, May P, Mallucci C. Endoscopic treatment of suprasellar and third ventricle-related arachnoid cysts.  Childs Nerv Sys. 2001;  17 713-718
    PubMedSearch in Google Scholar
  • 7 Inamasu J, Ohira T, Nakamura Y, Saito R, Kuroshima Y, Mayanagi K, Ohba S, Ichikizaki K. Endoscopic ventricle-cystostomy for non-communicating hydrocephalus secondary to quadrigeminal cistern arachnoid cysts.  Acta Neurol Scand. 2003;  107 67-71
    Search in Google Scholar
  • 8 Perneczky A. Comment to: Ruge JR et al. Burr hole neuroendoscopic fenestration of quadrigeminal cistern arachnoid cyst: technical case report.  Neurosurgery. 1996;  38 837
    PubMedSearch in Google Scholar
  • 9 Hopf N J, Perneczky A. Endoscopic neurosurgery and endoscope-assisted microneurosurgery for the treatment of intracranial cysts.  Neurosurgery. 1998;  43 1330-1337
    CrossrefPubMedSearch in Google Scholar
  • 10 Handa J, Nakano Y, Aii H. CT cisternography with intracranial arachnoid cysts.  Surg Neurol. 1997;  8 451-454
    PubMedSearch in Google Scholar
  • 11 Lee B CP. Intracranial cysts.  Radiology. 1979;  130 667-674
    PubMedSearch in Google Scholar
  • 12 Hayashi T, Kuratomi A, Kuramoto S. Arachnoid cysts of the quadrigeminal cistern.  Surg Neurol. 1980;  14 267-273
    PubMedSearch in Google Scholar
  • 13 Menzes A H, Bell W E, Perret G E. Arachnoid cysts in children.  Arch Neurol. 1980;  37 168-172
    PubMedSearch in Google Scholar
  • 14 Cilluffo J M, Onofrio B M, Miller R. The diagnosis and surgical treatment of intracranial arachnoid cysts.  Acta Neurochir (Wien). 1983;  67 215-229
    CrossrefPubMedSearch in Google Scholar
  • 15 Kaplan B J, Mickle J P, Parkhurst R. Cystoperitoneal shunting for congenital arachnoid cysts.  Child's Brain. 1984;  11 304-311
    PubMedSearch in Google Scholar
  • 16 Serlo W, Wendt L V, Heikkinen E, Sankonnen A L, Heikkinen E, Nystrom S T. Shunting procedures in the management of intracranial cerebrospinal fluid cysts in infancy and childhood.  Acta Neurochir. 1985;  76 111-116
    CrossrefPubMedSearch in Google Scholar
  • 17 Spaziante R, Cirillo S, Constans J P, de Divitiis E, Donzelli R, Stella L. Arachnoid cysts of the quadrigeminal cistern.  Neurochirurgia. 1986;  29 117-123
    PubMedSearch in Google Scholar
  • 18 Locatelli D, Bonfanti N, Sforgliarini R, Ganjo T M, Pezzotta S. Arachnoid cysts: Diagnosis and treatment.  Childs Nerv Syst. 1987;  3 121-124
    PubMedSearch in Google Scholar
  • 19 Hanieh A, Simpson D A, North J B. Arachnoid cysts: a critical review of 41 cases.  Childs Nerv Syst. 1988;  4 92-96
    PubMedSearch in Google Scholar
  • 20 Pagni C A, Canavero S, Vinci V. Left trochlear nerve palsy, unique symptom of an arachnoid cyst of the quadrigeminal plate. Case report.  Acta Neurochir (Wien). 1990;  105 147-149
    CrossrefPubMedSearch in Google Scholar
  • 21 Brotchi J, Levivier M, Raftopoulos C, Dewitte O, Pirotte B, Noterman J. Three quarter prone approach to the pineal-tentorial region: report of seven cases.  Acta Neurochir Suppl (Wien). 1991;  53 144-147
    PubMedSearch in Google Scholar

Michelangelo Gangemi,M. D. 

Department of Neurological Sciences · Unit of Neurosurgery · University “Federico II” of Naples

Via Pansini 5

80131 Naples

Italy

Phone: +39-81-746-2576/746-2583

Fax: +39-81-746-2594

Email: mgangemi@unina.it