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Acta Neurochirurgica
Published in: Acta Neurochirurgica 4/2016

01-04-2016 | Technical Note - Neurosurgical Techniques

Transaqueductal trans-Magendie fenestration of arachnoid cyst in the posterior fossa

Authors: Alberto Feletti, Matteo Alicandri-Ciufelli, Giacomo Pavesi

Published in: Acta Neurochirurgica | Issue 4/2016

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Abstract

Background

Neuroendoscopy is currently recommended as the first choice to treat posterior fossa arachnoid cysts. It has proven to be effective, providing improved outcome, and safe, having a low complication rate. Compared to craniotomy and shunt placement, it has lower surgical morbidity, minimizing or avoiding risks of subdural fluid collections, shunt infection, malfunction, overdrainage, and dependence. Usually, rigid scopes maneuvered through a suboccipital approach are used. When symptomatic obstructive hydrocephalus develops, CSF diversion is the first aim of surgery.

Methods

In these patients, a flexible scope introduced through a frontal burr hole allows not only immediate and efficient management of hydrocephalus with endoscopic third-ventriculostomy, but in selected cases also direct cyst inspection and fenestration. Navigation of an enlarged cerebral aqueduct is actually safe when performed by experienced neurosurgeons.

Results

We describe the cystocisternostomy of a cisterna magna arachnoid cyst using a transaqueductal trans-Magendie approach.

Conclusions

This minimally invasive technique gives the possibility of performing both endoscopic third-ventriculostomy and cyst fenestration, which alone may not be enough to efficiently treat hydrocephalus.
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Metadata
Title
Transaqueductal trans-Magendie fenestration of arachnoid cyst in the posterior fossa
Authors
Alberto Feletti
Matteo Alicandri-Ciufelli
Giacomo Pavesi
Publication date
01-04-2016
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 4/2016
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-016-2734-3

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