Quadrigeminal arachnoid cyst with perinatal encephalocele

Akutagawa, Kazuki; Tamura, Goichiro; Tsurubuchi, Takao; Ishikawa, Eiichi; Matsumura, Akira; Inagaki, Takayuki

doi:10.1007/s00381-020-04626-2

Cited by 7 publications

(2 citation statements)

References 18 publications

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“…Though arachnoid cysts are generally asymptomatic, they can produce symptoms with growth and lead to hydrocephalus and compressed adjacent brain structures due to fluid secretion from the cyst wall or entrapment of CSF through a valve-like mechanism 11) . Children with quadrigeminal cistern arachnoid cysts present with hydrocephalus symptoms, macrocephaly, ocular symptoms, and rare developmental delay 2,16) . Treatments of quadrigeminal cistern arachnoid cysts are numerous and include open craniotomy with cyst excision and shunting between cyst and cistern.…”

Section: Introductionmentioning

confidence: 99%

Neuroendoscopic Fenestration of Quadrigeminal Cistern Arachnoid Cyst Presenting with Developmental Regression

Kim

2022

Nerve

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Quadrigeminal cistern arachnoid cyst is rare and not usually located in the tectal plate region. Such a cyst may extend to the surrounding area and compress adjacent structures due to cystic expansion. Arachnoid cysts occasionally are associated with hydrocephalus and produce related symptoms. In our case, a 20-month-old boy presented with developmental regression and macrocephaly. Image study of the brain demonstrated a large cyst on the superior portion of the posterior fossa with extension to the supratentorial space and a compressed cerebellum inferiorly and brain stem anteriorly. Lateral and third ventricles were enlarged severely. We performed lateral ventriculo-cystostomy by neuroendoscope via a precoronal approach. Additional third ventriculostomy was performed on the floor of the third ventricle. At 9 months after surgery, the patient showed restored development, and postoperative image showed a reduction of arachnoid cysts and lateral and third ventricles.

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Section: Introductionmentioning

confidence: 99%

Neuroendoscopic Fenestration of Quadrigeminal Cistern Arachnoid Cyst Presenting with Developmental Regression

Kim

2022

Nerve

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“…3,6 While often asymptomatic and detected incidentally, large QACs can become symptomatic if they compress the brainstem or pineal region or cause obstructive hydrocephalus. 2,7 Children commonly present with symptoms of hydrocephalus, macrocephaly, developmental delay, or ocular symptoms from pineal compression, 1,3,5,8 but when patients make it…”

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confidence: 99%

Surgical management of quadrigeminal cistern arachnoid cysts: case series and literature review

Silva

Chang

Weng

et al. 2022

Journal of Neurosurgery: Pediatrics

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OBJECTIVE Quadrigeminal cistern arachnoid cysts (QACs) are congenital lesions that can cause pineal region compression and obstructive hydrocephalus when sufficiently large. Management of these cysts is controversial and rates of reintervention are high. Given the limited data on the management of QACs, the authors retrospectively reviewed 20 years of cases managed at their institution and performed a literature review on this topic. METHODS The authors performed a retrospective analysis of patients treated for QAC at their institution between 2001 and 2021. They also performed a literature review of studies published between 1980 and 2021 that reported at least 5 patients treated for QACs. Patient characteristics, radiographic findings, management course, and postoperative follow-up data were collected and analyzed. RESULTS A total of 12 patients treated for a QAC at the authors’ institution met the inclusion criteria for analysis. Median age was 9 months, mean cyst size was 5.1 cm, and 83% of patients had hydrocephalus. Initial treatment was endoscopic fenestration in 92% of these patients, 27% of whom had an endoscopic third ventriculostomy (ETV) performed concurrently. Reintervention was required in 42% of patients. Cases that required reintervention had a statistically significant lower median age at the initial intervention (5 months) than the cases that did not require reintervention (24.33 months; p = 0.018). There were no major complications. At a mean follow-up of 5.42 years, 83% of patients had improvement or resolution of their symptoms. A literature review revealed 7 studies that met the inclusion criteria, totaling 108 patients with a mean age of 8.8 years. Eighty-seven percent of patients had hydrocephalus at presentation. Ninety-two percent of patients were initially treated with endoscopic fenestration, 44% of whom underwent concurrent ETV. Complications occurred in 17.6% of cases, and reintervention was required in 30.6% of cases. The most frequent reason for reintervention was untreated or unresolved hydrocephalus after the initial procedure. CONCLUSIONS Endoscopic fenestration is the most common treatment for QACs. While generally safe and effective, there is a high rate of reintervention after initial treatment of QACs, which may be associated with a younger age at the first intervention. Additionally, identifying patients who require initial treatment of hydrocephalus is critically important, as the literature suggests that untreated hydrocephalus is a common cause of reintervention.

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