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Endoscopic treatment of suprasellar arachnoid cysts indenting third ventricle with obstructive hydrocephalus in
A Arslan1, V Acik1, S K Olguner1
1Department of Neurosurgery, Adana City Training and Research Hospital, Adana, Turkey.
Insights
Endoscopic treatment for pediatric suprasellar arachnoid cysts effectively relieved obstructive hydrocephalus. This minimally invasive approach reduced cyst size and improved intracranial pressure without requiring shunts.
Area of Science:
- Neurosurgery
- Pediatric Neurology
- Medical Imaging
Background:
- Suprasellar arachnoid cysts can cause obstructive hydrocephalus in children.
- Increased intracranial pressure is a common symptom.
Purpose of the Study:
- Evaluate the clinical utility of endoscopic treatment for pediatric suprasellar arachnoid cysts.
- Analyze clinical features and outcomes in thirteen treated children.
Main Methods:
- Retrospective analysis of thirteen pediatric patients (2012-2018).
- All patients underwent endoscopic treatment for suprasellar arachnoid cysts causing obstructive hydrocephalus.
- Assessment of clinical symptoms, cyst size, ventricular dimensions, and need for further interventions.
Main Results:
- Postoperative improvement in intracranial pressure and reduction in cyst and ventricle size.
- Enlargement of cortical sulci observed.
- One transient oculomotor nerve deficit; no shunt placements required.
- No recurrences detected during an average 36.8-month follow-up.
Conclusions:
- Endoscopic cyst fenestration and third ventriculostomy are effective and safe.
- Minimally invasive endoscopic procedures offer a superior alternative for treating these cysts in children.
Aims:
The present study aimed to evaluate the clinical usefulness of endoscopic treatment of suprasellar arachnoid cysts indenting the third ventricle with obstructive hydrocephalus and discuss the clinical features and outcomes of thirteen children treated at our institution.
Method:
We treated thirteen pediatric cases of suprasellar arachnoid cysts indenting the third ventricle with obstructive hydrocephalus between January 2012 and September 2018. Five female and eight male patients were enrolled in the study. The patients had increased intracranial pressure symptoms due to hydrocephaly. Endoscopic treatment was performed in all cases.
Results:
The patients were followed-up for an average of 36.8 months. The postoperative intracranial pressure findings improved. There was a reduction in the size of the cyst and ventricles and enlargement of the cortical sulci. One patient suffered transient oculomotor nerve deficit. No further surgical interventions, such as shunt placement, were required during the follow-up period. The head circumference of two of the patients with macrocephaly were stable during the follow-up. There were no postoperative recurrences detected.
Conclusions:
Endoscopic cyst fenestration and third ventriculostomy are less invasive, safer, and more effective ways to treat suprasellar arachnoid cysts indenting the third ventricle with obstructive hydrocephalus in children with hydrocephaly.
