Placement of subdural electrode grids for seizure focus localization in patients with a large arachnoid cyst

2007 ◽  
Vol 22 (2) ◽  
pp. 1-3 ◽  
Author(s):  
Medina C. Kushen ◽  
David Frim
Keyword(s):  
Arachnoid Cyst ◽  
Arachnoid Cysts ◽  
Electrode Arrays ◽  
Seizure Focus ◽  
Subdural Electrode ◽  
Focus Localization ◽  
Electrode Contact ◽  
The Brain ◽  
Cyst Cavity ◽  
Seizure Foci

✓Subdural electrode arrays are placed to localize seizure foci for possible resection. The procedure is usually straightforward when an electrode grid array is placed on the brain convexity but can become complicated if the surface on which the grids are applied is not convex. Arachnoid cysts can be associated with seizures, but their topography presents a challenge to standard techniques for the placement of subdural grids. The authors report on a technique for electrode grid placement that successfully localized seizure foci in the depths of arachnoid cysts in two patients. Subdural grids were placed to conform to the concave cyst cavity. They were held in place with rolled gelatin foam padding, which filled the arachnoid cyst. The padding was removed before removing the electrode grids and resecting the seizure focus. Although arachnoid cysts present a technical challenge when seizure foci are located within the cyst cavity, the technique of packing the cyst cavity with gelatin foam provides good electrode contact on the concave cyst wall, allowing adequate seizure focus localization.

Subdural electrode recordings for seizure focus localization

1989 ◽  
Vol 2 (3) ◽  
pp. 129-135 ◽  
Author(s):  
Thomas Jay Rosenbaum ◽  
Kenneth D. Laxer
Keyword(s):  
Seizure Focus ◽  
Subdural Electrode ◽  
Focus Localization

Subdural Electrodes for Seizure Focus Localization

Neurosurgery ◽  
1986 ◽  
Vol 19 (1) ◽  
pp. 73-81 ◽  
Author(s):  
Thomas J. Rosenbaum ◽  
Kenneth D. Laxer ◽  
Michael Vessely ◽  
W. Brewster Smith
Keyword(s):  
Electrode Placement ◽  
Surgical Decision ◽  
Electrode Implantation ◽  
Seizure Focus ◽  
Seizure Disorders ◽  
Depth Electrodes ◽  
Subdural Electrode ◽  
Focus Localization ◽  
Significant Addition ◽  
Made In

Abstract Fifty patients with medically refractory partial seizure disorders have undergone subdural electrode placement for seizure focus localization. Standard scalp telemetry recordings of ictal events had failed to demonstrate accurately the site of seizure onset, and these patients were considered candidates for telemetry with intracerebral depth electrodes. Excellent recordings of interictal and ictal events were obtained, and localization of the epileptogenic focus was derived from recordings made during spontaneously occurring seizures. Electrocorticograms were monitored for up to 21 days. The recordings enabled a surgical decision to be made in 43 of 50 cases (86%). Thirty patients have subsequently undergone cortical excision of their foci with good results. Subdural electrode recordings are a significant addition to the armamentarium of the neurosurgeon attempting to localize surgical seizure foci, offering a low morbidity procedure as an alternative to depth electrode implantation.

The Brain is Not Flat: Conformal Electrode Arrays Diminish Complications of Subdural Electrode Implantation, A Series of 117 Cases

2020 ◽  
Vol 144 ◽  
pp. e734-e742
Author(s):  
Brian A. Tong ◽  
Yoshua Esquenazi ◽  
Jessica Johnson ◽  
Ping Zhu ◽  
Nitin Tandon
Keyword(s):  
Electrode Arrays ◽  
Electrode Implantation ◽  
Subdural Electrode ◽  
The Brain

Importance of Fenestration Size for Definitive Treatment of a Quadrigeminal Arachnoid Cyst: Endoscopic Inspection of the Cyst and Surrounding Anatomy: 2-Dimensional Operative Video

2018 ◽  
Vol 16 (1) ◽  
pp. E12-E13 ◽  
Author(s):  
François Lechanoine ◽  
Pietro Spennato ◽  
Claudio Ruggiero ◽  
Giuseppe Cinalli
Keyword(s):  
Arachnoid Cyst ◽  
Endoscopic Treatment ◽  
Arachnoid Cysts ◽  
Definitive Treatment ◽  
Surgical Morbidity ◽  
Type Iii1 ◽  
Clinical And Radiological Outcome ◽  
Surgical Options ◽  
The Brain

Abstract Arachnoid cysts are fluid-filled sacs, located between the brain or spinal cord and the arachnoid membrane. Their prevalence in children is between 1% and 3%. Quadrigeminal arachnoid cysts represent 1% to 10% of them and are often associated with hydrocephalus, mostly by an obstructive mechanism, explained by compression of the tectum of the midbrain. When an indication for treatment is retained, 3 surgical options are available: microsurgical excision/fenestration, endoscopic fenestration, and shunt placement. Endoscopic treatment is considered the best compromise of definitive treatment with least surgical morbidity, especially because quadrigeminal cysts are located close to the midline, in intimate relationships with basal cisterns and ventricles. We here present the endoscopic treatment of a prenatally diagnosed quadrigeminal arachnoid cyst type III1 with right lateral extension into the middle cerebral fossa, and associated hydrocephalus, treated at the age of 18 mo. Step-by-step detail of surgical technique is presented in original anatomic conditions. Restoration of better cerebrospinal fluid pathways being the objective of this surgery, ventriculocystic, and cyst-cisternal fenestrations were made. Secondary obstruction of the cyst occurred a few months later, requiring further endoscopic treatment to obtain a larger fenestration that allowed good long-term clinical and radiological outcome. The key point of this video is to compare the 2 procedures, stressing the importance of the dimension of fenestrations, to ensure a long-term patency of both stomas. The patient being a child, both parents gave their consent for publication and signed a form.

Supratentorial intra-arachnoid cyst

1971 ◽  
Vol 35 (4) ◽  
pp. 477-482 ◽  
Author(s):  
Nitya R. Ghatak ◽  
Grace J. Mushrush
Keyword(s):  
Brain Stem ◽  
Arachnoid Cyst ◽  
Cerebral Hemisphere ◽  
Arachnoid Cysts ◽  
Neurological Deficits ◽  
Pathological Features ◽  
Content Type ◽  
The Brain ◽  
Clinical And Pathological Features ◽  
Fine Print

✓ The clinical and pathological features of a primary supratentorial arachnoid cyst are described. Expansion of the cyst led to progressive neurological deficits that terminated fatally. There was severe compression and marked distortion of the brain with secondary brain stem hemorrhage. It is suggested that intra-arachnoid cysts may represent a distinct pathological entity among the heterogeneous cysts overlying the cerebral hemisphere.

scholarly journals A Rare Case of Spontaneous Arachnoid Cyst Rupture Presenting as Right Hemiplegia and Expressive Aphasia in a Pediatric Patient

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 78
Author(s):  
Anne Bryden ◽  
Natalie Majors ◽  
Vinay Puri ◽  
Thomas Moriarty
Keyword(s):  
Cognitive Processing ◽  
Arachnoid Cyst ◽  
Memory Loss ◽  
Acute Onset ◽  
Word Finding ◽  
Outpatient Visits ◽  
The Family ◽  
History Of ◽  
Cyst Rupture ◽  
The Brain

This study examines an 11-year-old boy with a known history of a large previously asymptomatic arachnoid cyst (AC) presenting with acute onset of right facial droop, hemiplegia, and expressive aphasia. Shortly after arrival to the emergency department, the patient exhibited complete resolution of right-sided hemiplegia but developed headache and had persistent word-finding difficulties. Prior to symptom onset while in class at school, there was an absence of reported jerking movements, headache, photophobia, fever, or trauma. At the time of neurology consultation, the physical exam showed mildly delayed cognitive processing but was otherwise unremarkable. The patient underwent MRI scanning of the brain, which revealed left convexity subdural hematohygroma and perirolandic cortex edema resulting from ruptured left frontoparietal AC. He was evaluated by neurosurgery and managed expectantly. He recovered uneventfully and was discharged two days after presentation remaining asymptomatic on subsequent outpatient visits. The family express concerns regarding increased anxiety and mild memory loss since hospitalization.

A sacral arachnoid cyst causing holocord syringomyelia

2011 ◽  
Vol 8 (3) ◽  
pp. 299-302 ◽  
Author(s):  
Sumit Thakar ◽  
Narayanam Anantha Sai Kiran ◽  
Alangar S. Hegde
Keyword(s):  
Mr Imaging ◽  
Arachnoid Cyst ◽  
Complete Resolution ◽  
Spastic Paraparesis ◽  
Arachnoid Cysts ◽  
Sensory Loss ◽  
Low Back ◽  
Filum Terminale ◽  
Sensory Deficits

Spinal extradural arachnoid cysts (ACs) have an infrequent predilection for the sacrum. As with their counterparts in other regions of the spine, cysts in this location are mostly asymptomatic. Common presentations in symptomatic cases include pain in the low back or perineum, radiculopathy, and sphincteric dysfunction. The authors report a hitherto undescribed presentation in which the predominant symptoms are those related to an associated holocord syrinx. This 15-year-old boy presented with fluctuating, spastic paraparesis and a dissociated sensory loss in the trunk. Admission MR imaging of the spine showed an extradural AC from S-2 to S-4 and a holocord, nonenhancing syrinx. The patient underwent S-2 laminectomy, fenestration of the cyst, and partial excision of its wall. Intradural exploration revealed a normal-looking filum terminale and the absence of any dural communication with the cyst. At a follow-up visit 6 months after surgery, his motor and sensory deficits had resolved. Follow-up MR imaging showed complete resolution of the syrinx in the absence of the sacral AC. This is the first report of a sacral extradural AC causing holocord syringomyelia. Because conventional theories of syrinx formation were not helpful in elucidating this case, a hypothesis is postulated to explain the clinicoradiological oddity.

Giant syringobulbia associated with cerebellopontine angle arachnoid cyst and hydrocephalus

2011 ◽  
Vol 8 (1) ◽  
pp. 30-34 ◽  
Author(s):  
Ai Muroi ◽  
Nigel Peter Syms ◽  
Shizuo Oi
Keyword(s):  
Arachnoid Cyst ◽  
Head Circumference ◽  
Lateral Ventricle ◽  
Cerebellopontine Angle ◽  
External Ventricular Drainage ◽  
Magnetic Resonance Images ◽  
Ventricular Catheter ◽  
Cerebrospinal Fluid Diversion ◽  
Left Lateral Ventricle ◽  
The Brain

The aim in reporting this case was to discuss the pathophysiology and treatment issues in an infant with a giant syringobulbia associated with a right cerebellopontine angle (CPA) arachnoid cyst causing noncommunicating hydrocephalus. This 7-month-old infant presented to the hospital with a history of delayed milestones and an abnormal increase in head circumference. Magnetic resonance images and CT scans of the brain showed a large CSF cavity involving the entire brainstem and a right CPA arachnoid cyst causing obstruction of the fourth ventricle and dilation of the lateral and third ventricles. Cerebrospinal fluid diversion was performed by direct communication from the syringobulbia cavity to the left lateral ventricle and from the left lateral ventricle through another ventricular catheter; external ventricular drainage was performed temporarily for 5 days. Communication between the syrinx and arachnoid cyst was confirmed. Clinically, there was a reduction in head circumference, and serial MR imaging of the brain showed a decrease in the size of the syrinx cavity and the ventricle along with opening of the normal CSF pathways. The postoperative course was uneventful, and no further intervention was necessary. On follow-up of the child at 3 years, his developmental milestones were normal. Surgical intervention for this condition is mandatory. The appropriate type of surgery should be performed on the basis of the pathophysiology of the developing syringobulbia.

scholarly journals Intraventricular arachnoid cyst of lateral ventricle in an elderly patient

2020 ◽  
pp. 106-109
Author(s):  
Rajneesh Misra ◽  
Sushil Kumar ◽  
Sandeep Sharma ◽  
Pankaj Bharadva
Keyword(s):  
Elderly Patient ◽  
Arachnoid Cyst ◽  
Lateral Ventricle ◽  
Cystic Lesion ◽  
Arachnoid Cysts

Arachnoid cysts are usually located in relation to the arachnoid cisterns. Intra-ventricular location is rare and its embryological emergence in this site is controversial. We report a large intra-ventricular cyst in a 61-year-old female who presented with decreased vision, headache and right hemiparesis. MRI was suggestive of cystic lesion in the lateral ventricle and was excised completely through a craniotomy.

Cyst-ventricle stent as primary or salvage treatment for posterior fossa arachnoid cysts

2011 ◽  
Vol 7 (5) ◽  
pp. 549-556 ◽  
Author(s):  
Daniel H. Fulkerson ◽  
Todd D. Vogel ◽  
Abdul A. Baker ◽  
Neal B. Patel ◽  
Laurie L. Ackerman ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Arachnoid Cyst ◽  
Arachnoid Cysts ◽  
Morbidity Rate ◽  
Initial Symptom ◽  
Salvage Procedure ◽  
The Third ◽  
First Line Therapy ◽  
Posterior Fossa Cyst

Object The optimal treatment of symptomatic posterior fossa arachnoid cysts is controversial. Current options include open or endoscopic resection, fenestration, or cyst-peritoneal shunt placement. There are potential drawbacks with all options. Previous authors have described stenting a cyst into the ventricular system for supratentorial lesions. The current authors have used a similar strategy for posterior fossa cysts. Methods The authors performed a retrospective review of 79 consecutive patients (1993–2010) with surgically treated intracranial arachnoid cysts. Results The authors identified 3 patients who underwent placement of a stent from a posterior fossa arachnoid cyst to a supratentorial ventricle. In 2 patients the stent construct consisted of a catheter placed into a posterior fossa arachnoid cyst and connecting to a lateral ventricle catheter. Both patients underwent stent placement as a salvage procedure after failure of open surgical fenestration. In the third patient a single-catheter cyst-ventricle stent was stereotactically placed. All 3 patients improved clinically. Two patients remained asymptomatic, with radiographic stability in a follow-up period of 1 and 5 years, respectively. The third patient experienced initial symptom resolution with a demonstrable reduction of intracystic pressure. However, he developed recurrent headaches after 2 years. Conclusions Posterior fossa cyst–ventricle stenting offers the benefits of ease of surgical technique and a low morbidity rate. It may also potentially reduce the incidence of shunt-related headaches by equalizing the pressure between the posterior fossa and the supratentorial compartments. While fenestration is considered the first-line therapy for most symptomatic arachnoid cysts, the authors consider cyst-ventricle stenting to be a valuable additional strategy in treating these rare and often difficult lesions.

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