Huge arachnoid cyst in the posterior fossa: controversial discussion for selection of the surgical approach

Tsuboi, Yoshifumi; Hamada, Hideo; Hayashi, Nakamasa; Kurimoto, Masanori; Hirashima, Yutaka; Endo, Shunro

doi:10.1007/s00381-004-1006-3

Cited by 11 publications

(13 citation statements)

References 19 publications

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“…AC are benign developmental anomalies located within the arachnoid membrane, and mostly asymptomatic [3]. They are estimated to account for approximately 1% of all intracranial mass lesions [4]. Most AC are located in the middle cranial fossa [1].…”

Section: Discussionmentioning

confidence: 99%

Adult Posterior Cranial Fossa Arachnoid Cyst: A Case Report

Berete¹,

Bah²,

Hammas³

et al. 2019

OJMN

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Adult posterior fossa arachnoid cysts are rare lesions that are considered to be mostly congenital in origin. We present 49-year-old man admitted with a chief complaint of tremor and balance problems for the past 2 months. He had ataxia on examination. Magnetic resonance imaging revealed a well circumscribed midline cystic lesion of the posterior fossa sharing the same signal characteristics as cerebrospinal fluid and non-communicating to the fourth ventricle. He underwent surgical treatment for his symptomatic posterior fossa arachnoid cyst with a good outcome at 2 years follow up.

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Section: Discussionmentioning

confidence: 99%

Adult Posterior Cranial Fossa Arachnoid Cyst: A Case Report

Berete¹,

Bah²,

Hammas³

et al. 2019

OJMN

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“…Various treatment approaches exist, including microsurgical excision or fenestration by craniotomy, cyst shunting, and endoscopic fenestration. [ 1 3 11 14 18 22 24 ] While some authors have reported that there is no significant difference between these surgical methods,[ 2 8 ] studies evaluating the management of PFACs in a pediatric population demonstrated that craniotomy with excision was the first-line approach. [ 14 16 ] We selected to perform a microscopic membranectomy of both the inner and outer membranes because the resolution of obstructive hydrocephalus was a high priority and it was necessary to remove the mass effect to facilitate normal development of the infant.…”

Section: Discussionmentioning

confidence: 99%

“…In adults, the majority of intracranial arachnoid cysts arise in the supratentorial region (90%), with the middle cranial fossa being the most common site (60%) of origin and 10–20% of arachnoid cysts occurring in the posterior fossa. [ 4 7 22 ] In contrast, arachnoid cysts in infant patients commonly occur at the middle fossa (15%) and intraventicularly (14%), with very low percentages occurring in the posterior fossae (4.6%). [ 13 ] Lee et al .…”

Section: Introductionmentioning

confidence: 99%

“…Here, we present an extremely rare case of a 4-month-old boy who presented with a rapidly enlarging symptomatic PFAC. After considering the current options for treating symptomatic PFACs in infants,[ 1 3 11 14 18 22 24 ] we performed a necessary microscopic membranectomy with post-surgical percutaneous long-tunneled external ventricle drainage (PL-EVD)[ 5 15 ] and obtained a good outcome. Because this is the second successful case of surgical treatment for an enlarging symptomatic PFAC in an infant,[ 3 ] the surgical strategy described here can guide surgeons in future clinical decisions.…”

Section: Introductionmentioning

confidence: 99%

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Rare case of a rapidly enlarging symptomatic arachnoid cyst of the posterior fossa in an infant: A case report and review of the literature

et al. 2018

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Background:Intracranial arachnoid cysts are space-occupying lesions that typically remain stable or decrease in size over time. Cysts in infants younger than 1 year of age are remarkably different from those in older children and adults in terms of cyst localization and enlargement. Arachnoid cysts of the posterior fossa (PFACs) are very rare in infants and do not typically grow or present with clinical symptoms, such that surgical treatment is generally considered to be unnecessary. Here, we describe an extremely rare case of an infant with a rapidly enlarging symptomatic PFAC that was successfully treated with surgery.Case Description:A 4-month-old boy presented with increasing head circumference and a rapidly enlarging arachnoid cyst in the left posterior fossa with ventriculomegaly, which was documented using serial imaging over the preceding 2 months. We performed a microscopic resection of the cyst membrane to remove the mass effect as soon as possible and facilitate normal development. To confirm dural closure and prevent cerebrospinal fluid leakage, we also performed short-term (7 days) percutaneous long-tunneled external ventricle drainage after the surgery. Magnetic resonance imaging over a 4-year follow-up period revealed adequate reduction of the ventricle and cyst. The patient no longer exhibited progressive macrocrania and showed normal development.Conclusion:To our knowledge, this is the second successful case of surgical treatment of an enlarging symptomatic PFAC in an infant. Our surgical strategy for the treatment of this rare case can serve as a guide for surgeons in similar future cases.

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“…The characteristics of ACs vary remarkably between infants and older children or adults. In adults, the majority of intracranial ACs arise in the supratentorial region (90%), with the middle cranial fossa being the most common site (60%) of origin and 10–20% of ACs occurring in the posterior fossa [4-6]. In contrast, ACs in infant patients commonly occur at the middle fossa (15%) and intraventricular (14%), with very low percentages occurring in the posterior fossae (4.6%).…”

Section: Introductionmentioning

confidence: 99%

Giant Arachnoid Cyst Associated with an Orbital Meningocele: A Case Report and Cystoperitoneal Shunt Management

et al. 2021

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Introduction: Intracranial arachnoid cysts (ACs) are space-occupying lesions that typically remain stable in size and clinically silent over time. Case Report: We describe an unusual pediatric case of enlarged AC impressive by its compressive phenomena. An 11-month-old girl presented with remarkable macrocephaly associated with a cystic orbital tumor. CT scan and MRI studies revealed a large intracranial ACs extending in the orbit with an orbital meningocele (OM). The intracranial cyst did communicate with the orbital one into a bony defect in the right inner region of the orbital roof and represses the globe outward. A cystoperitoneal shunting procedure was performed to remove the mass effect as soon as possible and facilitate normal development. Discussion/Conclusion: Cysts in infants younger than 1 year of age are remarkably different from those in older children and adults in terms of cyst localization and enlargement. Classically described complications result from compression of adjacent structures and include focal neurologic involvement, headaches and seizures and developmental deficits, or macrocephaly in younger children. There are few cases of ACs with ophthalmic manifestations reported in the literature. The paucity of literature prompted us to analyze the case. To the best of our knowledge, an AC accompanying OM has not been reported. The pathogenesis and management of the case will be discussed.

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Huge arachnoid cyst in the posterior fossa: controversial discussion for selection of the surgical approach

Abstract: Magnetic resonance imaging 1 year after the operation revealed adequate reduction in the size of the ventricle and cyst. Progressive macrocrania discontinued and normal development was obtained.

Cited by 11 publications

References 19 publications

Adult Posterior Cranial Fossa Arachnoid Cyst: A Case Report

Adult Posterior Cranial Fossa Arachnoid Cyst: A Case Report

Rare case of a rapidly enlarging symptomatic arachnoid cyst of the posterior fossa in an infant: A case report and review of the literature

Giant Arachnoid Cyst Associated with an Orbital Meningocele: A Case Report and Cystoperitoneal Shunt Management

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