Endoscopic supracerebellar infratentorial parapineal approach for third ventricular colloid cyst in a patient with quadrigeminal cistern arachnoid cyst: Case report

Zanini, Marco Antônio; Rondinelli, Gilberto; Fernandes, Adriano Yacubian

doi:10.1016/j.clineuro.2012.06.032

Cited by 8 publications

(3 citation statements)

References 23 publications

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“…Endoscopic supracerebellar infratentorial approach can be used when the cyst is associated with a lesion such as an arachnoid cyst in the quadrigeminal cistern (63).…”

Section: Resultsmentioning

confidence: 99%

Management of colloid cyst of third ventricle

Yadav

Yadav²,

Parihar³

et al. 2014

Turkish Neurosurgery

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Colloid cysts are usually located in third ventricle and are believed to be derived from either primitive neuroepithelium or endoderm. Patients may remain asymptomatic for long time while some can present with paroxysmal headache, gait disturbance, nausea, vomiting, behavioral changes, weaknesses of lower limbs, impaired memory, new learning disability and sudden death. Computed tomography usually reveals a well-defined round or oval nonenhancing lesion. Although magnetic resonance imaging (MRI) signal intensity of colloid cysts is variable, the most common appearance is hyperintensity in T1-weighted sequences and iso to hypointensity in T2-weighted sequences. Observation, stereotactic aspiration, microscopic or endoscopic approaches and shunt surgery are various management options. Transcallosal and transcortical microscopic (with or without tubular retractor) approaches are mainly useful in normal-sized and dilated ventricles respectively. Endoscopic technique is an effective alternative to microsurgical technique but total resection and long-term recurrence remains a concern. Utilization of two instruments, the bi port technique and tubular retractor can be helpful in selected patients to overcome limitations. Although total excision should be aimed, subtotal excision and coagulation of residual cyst wall usually results in good long-term results without any growth of remnant wall. Conversion to an open procedure may be required in some patients.KEywords: Central nervous system cyst, Central nervous system neoplasm, Colloid cyst, Nervous system diseases, Third ventricle ÖZKolloid kistler genellikle üçüncü ventrikülde bulunur ve primitif nöroepitel veya endodermden köken aldıklarına inanılmaktadır. Hastalar uzun süre belirtisiz kalabilirler veya durum paroksismal baş ağrısı, yürüme bozukluğu, bulantı, kusma, davranış değişiklikleri, alt ekstremitelerde kuvvetsizlik, hafıza kaybı, yeni şeyler öğrenme zorluğu ve ani ölümle ortaya çıkabilir. Bilgisayarlı tomografi genellikle iyi tanımlanmış yuvarlak veya oval, kontrast tutmayan bir lezyon gösterir. Kolloid kistlerin manyetik rezonans görüntüleme (MRG) sinyal şiddeti değişkendir ama en sık rastlanan görünüm T1 ağırlıklı dizilerde hiperintens ve T2 ağırlıklı dizilerde izo ila hipointenstir. Gözlem, stereotaktik aspirasyon, mikroskopik veya endoskopik yaklaşımlar ve şant cerrahisi çeşitli tedavi seçenekleridir. Transkallosal ve transkortikal mikroskopik (tübüler retraktörle veya olmadan) yaklaşımlar temel olarak sırasıyla normal büyüklükte ve dilate ventriküllerde faydalıdır. Endoskopik teknik, mikrocerrahi tekniğe etkin bir alternatiftir ama total rezeksiyon imkanı ve uzun dönemde nüks olasılığı endişe yaratmaya devam etmektedir. İki alet kullanımı, iki portlu teknik ve tübüler retraktör bazı hastalarda sınırlamaları aşmak açısından faydalı olabilir. Total eksizyon hedeflenmelidir ama subtotal eksizyon ve kalan kist duvarının eksizyonu genellikle kalan duvarda bir büyüme olmadan uzun dönemli iyi sonuçlar verir. Bazı hastalarda açık cerrahiye dönmek de gerek...

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“…Endoscopic supracerebellar infratentorial approach can be used when the cyst is associated with a lesion such as an arachnoid cyst in the quadrigeminal cistern (63).…”

Section: Resultsmentioning

confidence: 99%

Management of colloid cyst of third ventricle

Yadav

Yadav²,

Parihar³

et al. 2014

Turkish Neurosurgery

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“…Tseng et al and Mamelak et al in 2013 were each the first to describe tumor resection in the pineal region using an endoscopic supracerebellar infratentorial approach [9][10]. Limitations to alternate approaches, such as the parapineal zone, have been cautioned by Zanini et al whose patient experienced lasting upward gaze palsy postoperatively [11]. In 2015, Zaidi et.al quantified optimal variants of the supracerebellar approach based on the region one wishes to target.…”

Section: Discussionmentioning

confidence: 99%

Laparoscope-Assisted Guidance to the Pineal Region

Fluss¹,

Kobets²,

Altschul³

et al. 2020

Cureus

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Tumors arising in the pineal region present a number of challenges when planning for effective removal. This report describes the successful resection of a falcotentorial meningioma occurring in a 56-year-old female using a supracerebellar infratentorial approach. In order to excise the pineal region mass, a unique combination of instrumentation was used, including a microscope, endoscope, and abdominal laparoscope. This technique afforded us passage to the pineal region, which allowed for enhanced visualization and maneuverability and was more amenable to decreasing the physical stress of the operating surgeon. This article is the first to detail the use of an abdominal laparoscope to remove a pineal tumor of this size for near-total resection. The various surgical approaches and tools traditionally used to remove pineal tumors are discussed, and the particular advantages and disadvantages of our hybrid approach are reviewed.

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“…Cyst-peritoneal shunt procedures carry some possibility of future shunt dependency and over drainage, but endoscopic surgery may avoid those complications. Many studies have discussed the role of endoscopic surgery in the treatment of intracranial arachnoid cysts, including some cases of QACs [6][7][8][11][12][13][14][15].…”

Section: Historical Backgroundmentioning

confidence: 99%

Quadrigeminal arachnoid cyst with perinatal encephalocele

et al. 2020

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Introduction Quadrigeminal arachnoid cyst (QAC) associated with encephalocele is rare; and while some treatments have been developed in recent years, no definite therapeutic approach for QAC has been established. Endoscopic treatment for arachnoid cyst is gaining popularity because it is relatively less invasive to the normal brain tissues. Case presentation The patient, a 4-year-old girl, presented with QAC associated with congenital occipital encephalocele. At the age of 1 month, repair of the perinatal encephalocele had been performed at another institute. An asymptomatic arachnoid cyst remained in the posterior fossa, which was closely monitored with follow up. At age 4 years, the patient started to complain of headache, which gradually increased in both strength and frequency. Magnetic resonance imaging (MRI) revealed cerebellar compression due to cyst enlargement. We performed neuroendoscopic cyst fenestration with an occipital bone approach. Post-operative MRI showed reduced size of the cyst, and the headache dramatically improved and resolved. Discussion The standard treatment of QAC is still controversial; however, our successful use of endoscopic fenestration toward the third ventricle indicates its efficacy and safety. QACs have been classified into 3 types based on their expansion mechanisms; our case might suggest another possible mechanism of QAC development. Conclusion In our case, endoscopic cyst fenestration was successful for QAC with perinatal encephalocele. However, long-term follow-up and analysis of similar cases are needed to determine its effectiveness.

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Endoscopic supracerebellar infratentorial parapineal approach for third ventricular colloid cyst in a patient with quadrigeminal cistern arachnoid cyst: Case report

Cited by 8 publications

References 23 publications

Management of colloid cyst of third ventricle

Management of colloid cyst of third ventricle

Laparoscope-Assisted Guidance to the Pineal Region

Quadrigeminal arachnoid cyst with perinatal encephalocele

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