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Resection of a Neuroenteric Cyst Using a Far Lateral Approach
Yair M Gozal1, Hussam Abou-Al-Shaar2, Vincent A DiNapoli1
1Mayfield Clinic, Cincinnati, Ohio, United States.
Journal of Neurological Surgery. Part B, Skull Base
|November 22, 2019
Summary
This video showcases a rare neuroenteric cyst at the craniocervical junction, successfully resected using a far lateral approach. Post-operative aseptic meningitis was managed effectively.
Area of Science:
- Neurosurgery
- Pathology
- Radiology
Background:
- A 30-year-old man presented with a 13-year history of a slowly enlarging ventral craniocervical junction mass.
- Initial diagnosis was meningioma, managed conservatively with serial imaging.
- The mass progressed to 1.4 cm, prompting elective surgical resection.
Purpose of the Study:
- To highlight a rare case of neuroenteric cyst at the ventral craniocervical junction.
- To demonstrate the surgical technique for resection via a far lateral approach.
- To discuss the histopathological findings and postoperative management.
Main Methods:
- A left far lateral approach was utilized for craniocervical junction mass resection.
- Surgical steps included suboccipital muscle dissection, C1 hemilaminectomy, and dural opening.
- Histopathology confirmed a neuroenteric cyst with goblet cells.
Main Results:
- Gross total resection of the neuroenteric cyst was achieved.
- The patient experienced no new neurological deficits postoperatively.
- Steroid-responsive aseptic meningitis developed, attributed to cyst content contamination.
Conclusions:
- Surgical resection via a far lateral approach is effective for ventral craniocervical junction neuroenteric cysts.
- Neuroenteric cysts are rare and can mimic other pathologies.
- Postoperative aseptic meningitis is a potential complication requiring management.
