Endoscopic management of quadrigeminal arachnoid cysts

Area of Science:

• Neurosurgery
• Pediatric Neurosurgery
• Neuroendoscopy

Background:

• Quadrigeminal cistern arachnoid cysts (QAC) are rare, comprising 5-10% of intracranial arachnoid cysts.
• QAC can cause hydrocephalus, macrocrania, and psychomotor retardation in infants, and intracranial hypertension in older children.

Purpose of the Study:

• To review the outcomes of neuroendoscopic intervention in patients with QAC.
• To evaluate the efficacy of neuroendoscopic procedures in different age groups.

Main Methods:

• Seventeen patients with QAC underwent neuroendoscopic surgery between 2000 and 2007.
• Procedures included ventriculocystostomy and endoscopic third ventriculostomy; aqueductal stents were used in two patients.
• Psychometric evaluation and clinical follow-up (6-96 months) were performed.

Main Results:

• Neuroendoscopic procedures were successful in all patients older than 6 months (P=0.005).
• Infants under 6 months often required ventriculo-peritoneal (VP) shunting, with only one of eight not needing a shunt.
• Macrocrania and psychomotor retardation were common in infants; older children presented with intracranial hypertension.

Conclusions:

• Neuroendoscopic intervention is an effective treatment for QAC, especially in patients over 6 months of age.
• Infants with QAC frequently require VP shunts due to developmental issues and hydrocephalus.