Endoscopic Fenestration of a Symptomatic Porencephalic Cyst in an Adult

2020 ◽  
Vol 141 ◽  
pp. 245-246
Author(s):  
David Wynne ◽  
Muhammad Fahmi Abdul Jalil ◽  
Rana Dhillon
Keyword(s):  
Porencephalic Cyst ◽  
Endoscopic Fenestration

scholarly journals Endoscopic treatment of suprasellar cysts without hydrocephalus

2016 ◽  
Vol 18 (4) ◽  
pp. 434-441 ◽  
Author(s):  
Song-Bai Gui ◽  
Sheng-Yuan Yu ◽  
Lei Cao ◽  
Ji-wei Bai ◽  
Xin-Sheng Wang ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Success Rate ◽  
Patient Outcomes ◽  
Endoscopic Treatment ◽  
Foramen Of Monro ◽  
Image Guided ◽  
Operative Complications ◽  
Appropriate Therapy ◽  
Endoscopic Fenestration

OBJECTIVE At present, endoscopic treatment is advised as the first procedure in cases of suprasellar arachnoid cysts (SSCs) with hydrocephalus. However, the appropriate therapy for SSCs without hydrocephalus has not been fully determined yet because such cases are very rare and because it is usually difficult to perform the neuroendoscopic procedure in patients without ventriculomegaly given difficulties with ventricular cannulation and the narrow foramen of Monro. The purpose of this study was to find out the value of navigation-guided neuroendoscopic ventriculocystocisternostomy (VCC) for SSCs without lateral ventriculomegaly. METHODS Five consecutive patients with SSC without hydrocephalus were surgically treated using endoscopic fenestration (VCC) guided by navigation between March 2014 and November 2015. The surgical technique, success rate, and patient outcomes were assessed and compared with those from hydrocephalic patients managed in a similar fashion. RESULTS The small ventricles were successfully cannulated using navigational tracking, and the VCC was accomplished in all patients. There were no operative complications related to the endoscopic procedure. In all patients the SSC decreased in size and symptoms improved postoperatively (mean follow-up 10.4 months). CONCLUSIONS Endoscopic VCC can be performed as an effective, safe, and simple treatment option by using intraoperative image-based neuronavigation in SSC patients without hydrocephalus. The image-guided neuroendoscopic procedure improved the accuracy of the endoscopic approach and minimized brain trauma. The absence of hydrocephalus in patients with SSC may not be a contraindication to endoscopic treatment.

Porencephalic Cyst

2013 ◽  
pp. 171-172
Author(s):  
Benjamin Huang
Keyword(s):  
Porencephalic Cyst

scholarly journals Neuroendoscopic fenestration of glioependymal cysts to the ventricle: report of 3 cases

2019 ◽  
Vol 131 (5) ◽  
pp. 1615-1619
Author(s):  
Anthony M. Alvarado ◽  
Kyle A. Smith ◽  
Roukoz B. Chamoun
Keyword(s):  
Minimally Invasive ◽  
Lateral Ventricle ◽  
Mass Effect ◽  
Ventricular System ◽  
Open Resection ◽  
Presenting Symptoms ◽  
Glioependymal Cyst ◽  
The Central Nervous System ◽  
Surgical Treatments ◽  
Endoscopic Fenestration

Glioependymal cysts are rare congenital lesions of the central nervous system. Reported surgical treatments of these lesions have varied and yielded mixed results, and the optimal surgical strategy is still controversial. The authors here report the clinical and surgical outcomes for three adult patients successfully treated with neuroendoscopic fenestration into the ventricular system. The patients had presented with symptomatic glioependymal cysts in the period from 2013 to 2016 at the authors’ institution. All underwent minimally invasive neuroendoscopic fenestration of the glioependymal cyst into the lateral ventricle via a stereotactically guided burr hole. Presenting clinical and radiological findings, operative courses, and postintervention outcomes were evaluated.All three patients initially presented with symptoms related to regional mass effect of the underlying glioependymal cyst, including headaches, visual disturbances, and hemiparesis. All patients were successfully treated with endoscopic fenestration of the cyst wall into the lateral ventricle, where the wall was thinnest. Postoperatively, all patients reported improvement in their presenting symptoms, and neuroimaging demonstrated decompression of the cyst. Clinical follow-up ranged from 4 months to 5 years without evidence of reexpansion of the cyst or shunt requirement.Compared to open resection and shunting of the cyst contents, minimally invasive endoscopic fenestration of a glioependymal cyst into the ventricular system is a safe and effective surgical option. This approach is practical, is less invasive than open resection, and appears to provide a long-term solution.

scholarly journals Iatrogenic Porencephalic Cyst after Surgery for Subdural Abscess: Report of Two Cases

2009 ◽  
Vol 18 (6) ◽  
pp. 470-473
Author(s):  
Daiya Ishigaki ◽  
Tsukasa Wada ◽  
Tomoyuki Kuwata ◽  
Kazuo Shibanai ◽  
Hiroshi Kashimura ◽  
...  
Keyword(s):  
Porencephalic Cyst ◽  
Subdural Abscess

scholarly journals Porencephalic Cyst in an Adult - A Rare Pathology

2021 ◽  
Vol 10 (12) ◽  
pp. 918-919
Author(s):  
Shreya Tapadia ◽  
Suresh Vasant Phatak ◽  
Harshith Gowda K.B ◽  
Asish Pavanan
Keyword(s):  
Cerebrospinal Fluid ◽  
White Matter ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Sudden Onset ◽  
Brain Parenchyma ◽  
Motor Deficits ◽  
Cystic Degeneration ◽  
Lateral Side ◽  
Porencephalic Cyst

Porencephalic cyst is a rare entity in adults with limited cases reported so far. It is usually congenital and seen in neonates. Here, we report a 25-year-old male who presented with post-ictal confusion following an episode of sudden onset of generalised tonic clonic seizure. He was diagnosed to have large cerebrospinal fluid (CSF) density cystic lesion in the right parieto-occipital region communicating with occipital horn on right side side of porencephaly. Porencephaly is an uncommon congenital disorder that occurs due to cystic degeneration and encephalomalacia leading to porencephalic cyst formation.1 They are considered to occur most commonly from focal encephalomalacia due to a localised cerebral insult during early gestation, 2 while the other aetiologies include trauma, infection, antenatal intraparenchymal haemorrhage and perinatal cerebral ischemia.3 If the insult occurs in late third trimester it can lead to gliosis. Porencephalic cysts are typically lined by white matter of brain parenchyma.2 They differ widely in their location and size while the clinical manifestations and presentations range from being asymptomatic to extremely impaired mental function. Generally, the signs and symptoms of porencephaly become apparent in the first year of life. The earliest manifestation being spasticity and seizures. As the age increases there is a delay in development of milestones presenting as language impairment, disability in intellect and motor deficits. Clinically head circumference measurement varies from being normal or small to an enlarged head in cases of synechiae formation that creates a one-way valve effect leading to progressive enlargement of the cyst and expansion of skull or there may be hydrocephalus.4 Radiologically the diagnosis depends on demonstrating a well-defined CSF-filled space occupying lesion lined by white matter and communicating with ventricles on computed tomography (CT) scan or magnetic resonance imaging (MRI) of brain. The prognosis of porencephaly depends on the location and extent of the cyst.5 If the cyst is very large it can cause mass effect in the form of scalloping of adjacent bone, buckling of brain parenchyma, midline shift to contra lateral side and hydrocephalus. On MRI, brain cyst appears well defined and lined by white matter with or without gliosis. Cerebrospinal fluid is the content which is shown as hypointense on T1 and hyperintense on T2.

scholarly journals Microsurgical treatment of a large posterior fossa arachnoid cyst

2020 ◽  
Vol 2 (3(September-December)) ◽  
pp. e592020
Author(s):  
Leopoldo Mandic Ferreira Furtado ◽  
José Aloysio da Costa Val Filho ◽  
François Dantas ◽  
Camila Moura De Sousa
Keyword(s):  
Posterior Fossa ◽  
Arachnoid Cyst ◽  
Motor Development ◽  
Fourth Ventricle ◽  
Open Surgery ◽  
Surgical Strategies ◽  
Development Delay ◽  
Microsurgical Resection ◽  
Cystoperitoneal Shunting ◽  
Endoscopic Fenestration

Introduction: Arachnoid cysts are fluid-filled malformations of the arachnoid tissue. A prevalence in children of 2,6% has been reported[2,3]. Surgical strategies of treatment include open surgery with cyst wall excision , endoscopic fenestration or cystoperitoneal shunting[1,4]. Methods: In this video case, we described the case of a 1 year and 7 months old child who presented with motor development delay, unable to walk, who underwent microsurgical resection of a large posterior fossa arachnoid cyst and communication with the fourth ventricle. Conclusion: Microsurgery approach provides a safe anatomic control over the cyst and the recognition of floor of the fourth ventricle.  

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