Transventricular transforaminal endoscopic fenestration with cysto-ventriculoperitoneal shunt to manage a third ventricular arachnoid cyst: a case report

  • Nia Yuliatri Department of Neurosurgery, Mayapada Hospital, Jakarta, Indonesia
  • Ingrid Ayke Widjaya Department of Neurosurgery, Mayapada Hospital, Jakarta, Indonesia https://orcid.org/0000-0002-7248-5591
  • Alphadenti Harlyjoy Department of Neurosurgery, Mayapada Hospital, Jakarta, Indonesia
  • Gibran Aditiara Wibawa Department of Neurosurgery, Mayapada Hospital, Jakarta, Indonesia
  • Satyanegara Department of Neurosurgery, Mayapada Hospital, Jakarta, Indonesia
Keywords: cerebrospinal fluid shunt, endoscopic fenestration, transforaminal, transventricular
Abstract viewed: 237 times
PDF downloaded: 130 times
HTML downloaded: 26 times
EPUB downloaded: 44 times

Abstract

Regular ventriculoperitoneal (VP) shunt is commonly used as the first option to manage a third ventricular arachnoid cyst due to the lack of facilities, unfamiliarity with endoscopic techniques, or misdiagnosis as purely obstructive hydrocephalus. A 9-year-old girl with obstructive hydrocephalus due to a third ventricular arachnoid cyst was treated with a VP shunt. 2 months later, the previous shunt device was removed due to an infection. Following a sterile cerebrospinal fluid analysis culture, we conducted a navigation-assisted transventricular transforaminal endoscopic fenestration and cysto-VP programmable shunt placement. A decrease in ventricular dilatation was seen on follow-up. This approach was justified due to the possibility of establishing communication with normal cisterns, the high rate of cyst elimination, and the potential for achieving shunt independence. Performing an endoscopic fenestration followed by cysto-VP shunt placement could be an optimal option for managing this condition.

References

  1. Helland CA, Wester K. A population based study of intracranial arachnoid cysts: clinical and neuroimaging outcomes following surgical cyst decompression in adults. J Neurol Neurosurg Psychiatry. 2007;78(10):1129-35. https://doi.org/10.1136/jnnp.2006.107995

  2. Copley P, Kirkman MA, Thompson D, James G, Aquilina K. Endoscopic surgery for intraventricular arachnoid cysts in children: clinical presentation, radiological features, management, and outcomes over a 12-year period. Child's Nerv Syst. 2018;34(2):257-66. https://doi.org/10.1007/s00381-017-3524-9

  3. Kelly KA, Sherburn MM, Sellyn GE, Ahluwalia R, Foster J, Shannon CN, et al. Management of suprasellar srachnoid cysts in children: a systematic literature review highlighting modern endoscopic approaches. World Neurosurg. 2020;141:e316-23. https://doi.org/10.1016/j.wneu.2020.05.122

  4. Sprau AC, McCrea HJ. Intracranial arachnoid cysts in an infant: a technical note on the innovative use of navigation and flexible endoscopy for cyst fenestration. Surg Neurol Int. 2021;12:160. https://doi.org/10.25259/SNI_81_2021

  5. El-Ghandour NMF. Endoscopic treatment of intracranial cysts in infants: personal experience and review of literature. Child's Nerv Syst. 2021;37(11):3447-53. https://doi.org/10.1007/s00381-021-05264-y

  6. Erşahin Y, Kesikçi H, Rüksen M, Aydin C, Mutluer S. Endoscopic treatment of suprasellar arachnoid cysts. Child's Nerv Syst. 2008;24(9):1013-20. https://doi.org/10.1007/s00381-008-0615-7

  7. Gangemi M, Colella G, Magro F, Maiuri F. Suprasellar arachnoid cysts: endoscopy versus microsurgical cyst excision and shunting. Br J Neurosurg. 2007;21(3):276-80. https://doi.org/10.1080/02688690701339197

  8. Mustansir F, Bashir S, Darbar A. Management of arachnoid cysts: a comprehensive review. Cureus. 2018;10(4):e2458. https://doi.org/10.7759/cureus.2458

  9. Kirollos RW, Javadpour M, May P, Mallucci C. Endoscopic treatment of suprasellar and third ventricle-related arachnoid cysts. Child's Nerv Syst. 2001;17(12):713-8. https://doi.org/10.1007/s003810100494

  10. Ma GF, Li CZ, Zhang YZ, Wang XS, Zhao P, Gui SB. A good choice for the patients with prior failed ventriculoperitoneal shunt treatment of suprasellar arachnoid cysts: endoscopic fenestration. Neurosurg Rev. 2020;43(5):1373-81. https://doi.org/10.1007/s10143-019-01152-x

  11. Hayes MJ, TerMaath SC, Crook TR, Killeffer JA. A review on the effectiveness of surgical intervention for symptomatic intracranial arachnoid cysts in adults. World Neurosurg. 2019;123:e259-72. https://doi.org/10.1016/j.wneu.2018.11.149

  12. Özek MM, Urgun K. Neuroendoscopic management of suprasellar arachnoid cysts. World Neurosurg. 2013;79(2 suppl):S19.e13-8. https://doi.org/10.1016/j.wneu.2012.02.011

  13. Alexiou GA, Varela M, Sfakianos G, Prodromou N. Shunting for the treatment of arachnoid cysts in children. Neurosurgery. 2010;67(6):1632-6. https://doi.org/10.1227/NEU.0b013e3181f94476

  14. Tamburrini G, Caldarelli M, Massimi L, Santini P, Di Rocco C. Subdural hygroma: an unwanted result of Sylvian arachnoid cyst marsupialization. Childs Nerv Syst. 2003;19(3):159-65. https://doi.org/10.1007/s00381-003-0724-2

  15. Akpinar E, Gürbüz MS, Okutan MÖ, Beşkonakli E. Third ventricle arachnoid cyst presenting with acute hydrocephalus: a case report and review of the literature. Medeni Med J. 2018;33(3):247-51. https://doi.org/10.5222/MMJ.2018.67878

  16. Pitsika M, Sgouros S. Volume change of cranial arachnoid cysts after successful endoscopic fenestration in symptomatic children. Childs Nerv Syst. 2019;35(12):2313-8. https://doi.org/10.1007/s00381-019-04315-9

  17. El Refaee E, Elbaroody M. Endoscopic fenestration of arachnoid cysts through lateral pontomesencephalic membranotomy: technical note and case series. World Neurosurg. 2021;148:54-64. https://doi.org/10.1016/j.wneu.2020.12.108

  18. Mottolese C, Szathmari A, Simon E, Ginguene C, Ricci-Franchi AC, Hermier M. The parallel use of endoscopic fenestration and a cystoperitoneal shunt with programmable valve to treat arachnoid cysts: experience and hypothesis. J Neurosurg Pediatr. 2010;5(4):408-14. https://doi.org/10.3171/2009.11.PEDS08435

  19. Cinalli G, Spennato P, Ruggiero C, Aliberti F, Trischitta V, Buonocore MC, et al. Complications following endoscopic intracranial procedures in children. Childs Nerv Syst. 2007;23(6):633-44. https://doi.org/10.1007/s00381-007-0333-6

  20. Oi S. Classification and definition of hydrocephalus: origin, controversy, and assignment of the terminology. In: Cinalli G, Sainte-Rose C, Maixner WJ, editors. Pediatric Hydrocephalus. Springer; 2005. p. 95-111. https://doi.org/10.1007/978-88-470-2121-1_6

  21. Choi JU, Kim DS, Huh R. Endoscopic approach to arachnoid cyst. Childs Nerv Syst. 1999;15(6-7):285-91. https://doi.org/10.1007/s003810050396

Published
2023-10-17
How to Cite
1.
Yuliatri N, Widjaya IA, Harlyjoy A, Wibawa GA, Satyanegara. Transventricular transforaminal endoscopic fenestration with cysto-ventriculoperitoneal shunt to manage a third ventricular arachnoid cyst: a case report. Med J Indones [Internet]. 2023Oct.17 [cited 2024May27];32(3):194-7. Available from: https://mji.ui.ac.id/journal/index.php/mji/article/view/6856
Section
Case Report/Series