Endoscopic Treatment of a Fourth Ventricle Arachnoid Cyst via the Third Ventricle

Abstract

Endoscopic fenestration of fourth ventricle arachnoid cysts may be considered an effective neurosurgical treatment.

Pure endoscopic management of fourth ventricle arachnoid cyst: Case report and literature review

“…The first case of a fourth ventricle AC successfully managed by an endoscopic procedure alone via the third ventricle was recently reported by Martinoni et al . ;[ 10 ] the former technique has the advantage of allowing both a cyst fenestration and a third ventriculocisternostomy at the same stage. This procedure might prevent the occurrence of hydrocephalus in case of impeded free pericystic CSF circulation or cyst recurrence, representing a remarkable advantage compared to simple CSF diversion.…”

“…Martinoni et al [10] 32 years Normal pressure hydrocephalus Surgery (IGS) system was used (BrainLab VectorVision).…”

Endoscopic management of a fourth ventricular cyst

“…Endoscopic management of arachnoid cyst has been shown to be an effective and safe method. [ 10 11 12 ] Microsurgical cyst fenestration or shunting procedures can be performed subsequently if the endoscopic procedure failed. [ 9 13 ] Microsurgical complete cyst resection was associated with the complete recovery and resolution of the cyst;[ 2 3 14 15 16 17 18 ] however, a case of postoperative mortality due to cerebral ischemic stroke was reported.…”

“…[ 21 ] Modern neuroendoscopic techniques offer direct and close visualization of the cyst,[ 5 ] and their minimal invasiveness leads to less postoperative complications than the open surgery. [ 12 ]…”

“…The alternative approach, i.e., through the third ventricle, would provide the opportunity to perform an endoscopic third ventriculostomy (ETV). [ 12 ] Since the patient already had a VP shunt, we did not find it necessary to perform an additional ETV. Thus, we chose the closer and safer route to the cyst.…”