Endoscopic Multiple Wide Fenestrations of Intraventricular Arachnoid Cyst Arising in Lateral Ventricle

ABSTRACT

Intraventricular arachnoid cyst is an uncommon disease and a few surgical experiences have been reported. The authors present an experience of neuroendoscopic surgery in a 4-year-old-male patient with a large arachnoid cyst arising from the right lateral ventricle, who had suffered from generalized tonic clonic seizure. On operation, various portions of the cyst could be easily approached without unwanted parenchymal injury because most of the cystic membrane was movable and not adherent to the ventricular wall except choroid plexus area, which could be considered as origin site of the cyst. Marked shrinkages by electrocoagulation and multiple wide fenestrations of the cyst were obtained through the endoscopic working channel without difficulty. Postoperative brain computed tomography demonstrated decreasing ventricular size with no evidence of cystic recurrence. The postoperative course was uneventful for eight months follow-up period. We suggest that endoscopic procedure has definite advantages as the surgical method of choice for the treatment of intraventricular arachnoid cysts.