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Acta Neurochirurgica

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01-12-2020 | Craniotomy | Original Article - CSF Circulation

Endoscopic management of pineal cyst-associated aqueductal stenosis

Author: Laurence Davidson

Published in: Acta Neurochirurgica | Issue 12/2020

Abstract

Object

The purpose of this study was to evaluate whether endoscopic third ventriculostomy (ETV) and endoscopic cyst fenestration are effective minimally invasive alternatives to a craniotomy with cyst resection for the treatment of symptomatic pineal cyst-associated aqueductal stenosis.

Methods

Sixteen patients with symptomatic pineal cysts were operatively managed endoscopically and these cases were retrospectively reviewed. There were 12 females and 4 males. The median age at the time of surgery was 31 years (range 3 to 62 years).

Results

All patients presented with symptoms and imaging consistent with elevated intracranial pressure. The median maximum cyst diameter was 15 mm (range 10 mm to 27 mm). In all cases, there was mass effect on the tectum that resulted in effacement of the cerebral aqueduct and ventriculomegaly was present in 38% of cases. ETV was performed in 15 patients. Cyst fenestration was performed in 2 patients, one of which also had an ETV. Resolution of symptoms was achieved in 81% of patients with a median follow-up of 13 months.

Conclusion

This study showed that ETV is effective for symptomatic pineal cyst-associated aqueductal stenosis. Patients can be symptomatic without overt ventriculomegaly and normal ventricular volume does not preclude safe endoscopic management. Endoscopic cyst fenestration is recommended if a Perinaud syndrome is present or if ETV is not feasible.

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Title: Endoscopic management of pineal cyst-associated aqueductal stenosis
Author: Laurence Davidson
Publication date: 01-12-2020
Publisher: Springer Vienna
Keywords: Craniotomy
Headache
Acetazolamide
Published in: Acta Neurochirurgica / Issue 12/2020
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-020-04419-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Endoscopic management of pineal cyst-associated aqueductal stenosis

Abstract

Object

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Object

Methods

Results

Conclusion

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