Endoscopic management of posterior fossa arachnoid cyst in an adult: case report and technical note

Gazioğlu, Nurperi; Kafadar, Ali; Tanrıöver, Necmettin; Abuzayed, Bashar; Biçeroğlu, Hüseyin; Çiplak, Nejat

doi:10.5137/1019-5149.jtn.2493-09.1

Cited by 5 publications

(5 citation statements)

References 34 publications

(59 reference statements)

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“…in most studies as the improvement or regression of at least one symptom (15,28). Despite the use of different surgical techniques, clinical improvement was reported in all studies (1,7,19,31).…”

Section: Discussionmentioning

confidence: 99%

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Comparison of surgical techniques for intracranial arachnoid cysts: a volumetric analysis

Kırmızıgöz¹,

Doğan²,

Kayhan³

et al. 2023

Turkish Neurosurgery

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AIM:To compare volumetric changes of intracranial arachnoid cysts (IACs) in different surgical techniques. MATERIAL and METHODS:Sixty-six patients who underwent IAC surgery in our department between 2010 and 2020 were studied retrospectively. Based on the surgical technique, clinical and volumetric changes, postoperative complications, recurrence rates, and length of hospital stay were statistically compared. RESULTS:Microsurgical fenestration (MF) was performed on 32 (48.5%) patients, endoscopic fenestration (EF) on 17 patients, cystoperitoneal shunt (CPS) on 11 patients, and EF + CPS in six patients. The mean IAC volume change rate was 68.54 mL, and the mean cyst volume change rate was 40.68%. The MF technique produces a significantly greater mean cyst volume change than the EF technique. The mean volume change in sylvian IAC is 4.8 times greater than in posterior fossa IAC, a significant difference. The mean cyst volume change is four times greater in patients with skull deformity than in patients with balance loss, and this difference is statistically significant. In patients with cranial deformity, the mean cyst volume change is 2.6 times greater than in patients with neurological dysfunction. This difference is also statistically significant. The volume of IAC decreased more in patients with postoperative complications, with a significant difference between the postoperative complication and the change in IAC volume.CONCLUSION: MF can achieve better volumetric reduction in IAC, particularly in patients with sylvian arachnoid cysts. However, more volumetric reduction increases the risk of postoperative complications.

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Section: Discussionmentioning

confidence: 99%

“…The improvement of clinical and radiological symptoms is considered in determining the surgical technique's effectiveness (9,15,19,28). Clinical improvement was defined tion techniques are now classified as microsurgical and endoscopic.…”

Section: Discussionmentioning

confidence: 99%

Comparison of surgical techniques for intracranial arachnoid cysts: a volumetric analysis

Kırmızıgöz¹,

Doğan²,

Kayhan³

et al. 2023

Turkish Neurosurgery

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“…This increase in size is usually secondary to pressure gradient and oscillatory changes with the same diastolic pressure. Other theories mention the fact that the expansion of the cyst may be linked to the direct liquid secretion of the cyst lining by the arachnoid cells that form the wall or by ectopic structures similar to choroids [9][10][11] . Similarly, obstructive hydrocephalus has been described as a common presentation.…”

Section: Discussionmentioning

confidence: 99%

Arachnoid interamigdal cyst of the posterior fossa in an adult female

Pelayo-Salazar¹,

Sosa-Martínez²,

Juárez-Rebollar³

et al. 2020

RMU

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Introduction: Arachnoid cysts are benign extracerebral collections of cerebrospinal fluid; a very low incidence has been described as part of all intracranial lesions (about 1%). They appear in the different anatomical areas of the neuroaxis where arachnoids exist; the majority are supratentorial and in the middle fossa (50-60%). In general, less than 50% of cases present manifestations that merit surgical treatment. Case report: A 55-year-old female underwent surgery due to torpid evolution as a result of an arachnoid cyst in the posterior fossa. She started suffering from episodes of pulsatile headache 2 years ago without irradiation accompanied by occasional vertigo that was attenuated with conventional analgesia. In the past week, the pain was exacerbated, as was the vertigo, intolerance to the oral route, and generalized weakness. A scheduled surgical intervention was decided on, and a histopathological study reported characteristics compatible with an arachnoid cyst. Discussion: Arachnoid cysts are an uncommon pathology that sometimes requires surgical intervention. In the case presented, the incipient clinic manifestations showed that the patient had an abrupt progression in her intensity, perhaps due to an increase in size, conditioning the increasing headache, and added symptoms. This culminated in her assessment and surgical intervention due to the important compression of the brain stem. It was considered a successful procedure due to the disappearance of the symptoms and the return to her activities. Conclusions: Surgical intervention for posterior fossa arachnoid cyst is an excellent treatment when the symptoms do not improve after having maintained an expectant conduct through conservative management.

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“…However, because the wall was not completely removed (due to its adherence to the adjacent brain tissues and because of the technological limitations during intracranial manipulation), the cyst eventually refilled, and resulted in recurrence of the clinical signs and symptoms. In human neurosurgery, the management of arachnoid cysts includes open craniotomy and cyst marsupialization followed by the insertion of a cystoperitoneal shunt (35, 37, 38). These methods cannot be used for pituitary gland surgery in dogs, in which the location of intracranial cysts can be very diverse.…”

Section: Discussionmentioning

confidence: 99%

A Recurrent Suprapituitary Ependymal Cyst Managed by Endoscopy-Assisted Transsphenoidal Surgery in a Canine: A Case Report

Lehner

Garamvölgyi

Jakab³

et al. 2019

Front. Vet. Sci.

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A 9-years-old spayed female mixed-breed dog was referred for the evaluation of intermittent head tremors, obtundation, long-standing blindness, and a tendency to seek confined spaces. The dog lost its vision 6 months before the current presentation. A menace response was absent on ophthalmological examination. Neurological examination did not show any abnormalities. A cyst measuring 16 × 18 × 14 mm was observed above the pituitary gland on magnetic resonance imaging. It extended toward the frontal area and compressed the optic chiasm and hypothalamic regions. A minimum preoperative database, including the findings of other required blood tests, was prepared. No abnormal laboratory findings were observed. Endoscopy-assisted transsphenoidal hypophysectomy was performed to remove the pituitary gland, drain the cyst, and partially excise the cyst wall. Normal pituitary gland tissue was observed on histopathology, and the mass was found to have a neuroendocrine or ependymal origin on cytology. Strict post-operative laboratory tests were performed at 1-h intervals for 24 h. An empty sella turcica region, and a collapsed and empty cyst wall was observed on follow-up magnetic resonance imaging. After 3 days of observation, the dog was discharged with a prescription of substitution therapy. However, the dog presented with the same signs and symptoms 73 days after the surgery. Cyst recurrence was apparent on magnetic resonance imaging. The owner requested euthanasia, and an ependymal cyst was observed on necropsy. To the best of our knowledge, we present the first case of an intra- and suprasellar ependymal cyst, and its surgical management in a canine. The findings from this case suggest that endoscopic transsphenoidal drainage and hypophysectomy could be a good surgical approach in cases where involvement of the pituitary gland is confirmed or strongly suspected on the basis of cytological and imaging findings.

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Endoscopic management of posterior fossa arachnoid cyst in an adult: case report and technical note

Cited by 5 publications

References 34 publications

Comparison of surgical techniques for intracranial arachnoid cysts: a volumetric analysis

Comparison of surgical techniques for intracranial arachnoid cysts: a volumetric analysis

Arachnoid interamigdal cyst of the posterior fossa in an adult female

A Recurrent Suprapituitary Ependymal Cyst Managed by Endoscopy-Assisted Transsphenoidal Surgery in a Canine: A Case Report

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