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.

scholarly journals Intramedullary Arachnoid Cyst of the Cervical Spine: Case Report and Literature Review

2017 ◽  
Vol 36 (04) ◽  
pp. 256-259 ◽  
Author(s):  
Saleh Baeesa ◽  
Abdalrahman Aljameely
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Arachnoid Cyst ◽  
Arachnoid Cysts ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
Benign Lesions ◽  
Clinical And Radiological Results

AbstractIntramedullary arachnoid cysts of the spinal cord are extremely rare benign lesions of unclear pathogenesis. To our knowledge, only 21 cases were reported in the literature, 10 of which involved the cervical spine. We report the case of a 47-year-old female who presented with a symptomatic spinal intramedullary arachnoid cyst (SIAC). Magnetic resonance imaging scan of the cervical spine demonstrated an intramedullary arachnoid cyst at C3-C5 level. The patient had a cervical laminectomy and cysto-subarachnoid shunt with rapid and excellent clinical recovery and no recurrence at 2-year follow-up.Intramedullary arachnoid cysts should be considered in the differential diagnosis of intramedullary cystic lesions of the spinal cord. Their pathogenesis and natural history are not well defined in the literature. However, a cysto-subarachnoid shunt can be performed with excellent long-term clinical and radiological results.

Endoscopic Treatment of Intracranial Arachnoid Cysts: A Retrospective Analysis of a 25-Year Experience

2020 ◽  
Vol 20 (1) ◽  
pp. 32-44 ◽  
Author(s):  
Joachim Oertel ◽  
Stefan Linsler ◽  
Wolfgang Wagner ◽  
Michael Gaab ◽  
Henry Schroeder ◽  
...  
Keyword(s):  
Endoscopic Treatment ◽  
Arachnoid Cysts ◽  
Invasive Technique ◽  
Complication Rates ◽  
Patients Âgés ◽  
Endoscopic Techniques ◽  
Long Term Follow Up ◽  
Shunt Dependency

Abstract BACKGROUND Since the development of neuroendoscopy, pure endoscopic fenestration for intracranial arachnoid cysts (ACs) became more and more popular and is actually preferred by many neurosurgeons. OBJECTIVE To explore their techniques and experiences with endoscopic treatment of intracranial ACs over a 25-yr period. METHODS A total of 95 endoscopic procedures in 87 patients with 88 intracranial ACs performed at the authors’ departments between February 1993 and October 2018 were retrospectively analyzed. Particular respect was given to surgical technique, complications, patients’ outcome, and radiological benefit in relation to cyst location. RESULTS Patients’ ages ranged from 23 d to 81 yr (mean: 29.9 yr). Cysts were located temporobasal (n = 31; 35.2%), paraxial supratentorial (n = 14; 15.9%), suprasellar/prepontine (n = 14; 15.9%), quadrigeminal (n = 12; 13.6%), infratentorial (n = 11; 12.5%), and supratentorial intraventricular (n = 6; 6.8%). Four different endoscopic techniques were applied: cystocisternostomies (n = 48; 50.5%), ventriculocystostomies (n = 23; 24.2%), cystoventriculostomies (n = 14; 14.7%), and ventriculocystocisternostomies (n = 10; 10.5%). Pure endoscopic technique was feasible in 89 of the 95 surgeries (93.7%). Clinical improvement was documented after 82 surgeries (86.3%) and radiological benefit after 62 surgeries (65.3%). Recurrences developed in 8 cases (8.4%). Overall complication rate was 21.1% (n = 20), postoperative new shunt dependency was observed in 4.2% of the cases (n = 4). CONCLUSION Pure endoscopic AC fenestration is a safe, effective, and less invasive technique providing high success and low permanent complication rates. The most frequent temporobasal cysts are the most difficult to treat endoscopically. A long-term follow-up is recommended because recurrences may occur many years after first treatment.

scholarly journals Long-term Follow-up of a Multiloculated Arachnoid Cyst of the Middle Cranial Fossa

2007 ◽  
Vol 86 (6) ◽  
pp. 338-341 ◽  
Author(s):  
Marc A. Cohen ◽  
Noam A. Cohen ◽  
Gul Moonis ◽  
David W. Kennedy
Keyword(s):  
Arachnoid Cyst ◽  
Radiographic Progression ◽  
Middle Cranial Fossa ◽  
Arachnoid Cysts ◽  
Close Observation ◽  
Long Term Follow Up ◽  
Intracranial Lesions ◽  
Cranial Fossa

Arachnoid cysts are benign intracranial lesions that are typically diagnosed incidentally. We describe the case of a 56-year-old man who presented with a multiloculated arachnoid cyst of the middle cranial fossa that extended into the sphenoid sinus. The lesion was identified on computed tomography of the head, which had been obtained for an unrelated investigation. However, establishing a definitive diagnosis proved to be difficult. Because the cyst had caused extensive skull base erosion, the patient was managed conservatively with close observation. We report the radiographic progression of this lesion during more than a decade of follow-up, and we review the literature pertaining to the presentation, pathophysiology, and treatment of arachnoid cysts.

scholarly journals Rare occurrence of a huge traumatic extradural haematoma in a patient with an ipsilateral sylvian arachnoid cyst

2018 ◽  
Vol 11 (1) ◽  
pp. bcr-2018-227525
Author(s):  
Haider Tawfeeq Alhillo ◽  
Hatem Azet Sadik ◽  
Teeba N Gheni ◽  
Samer S Hoz
Keyword(s):  
Emergency Department ◽  
Arachnoid Cyst ◽  
Glasgow Coma Score ◽  
Extradural Haematoma ◽  
Rare Occurrence ◽  
Surgical Evacuation ◽  
Surgical Options ◽  
The Brain

A man, a teenage victim of an assault to the head, presented to the emergency department, in Baghdad, with a Glasgow Coma Score of 4/15 (E1 M2 V1) and total right-sided paralysis. CT of the brain revealed a large-left sided frontotemporoparietal extradural haematoma with the presence of an ipsilateral sylvian arachnoid cyst deep to the haematoma. Urgent surgical evacuation of the haematoma was performed, leaving the arachnoid cyst intact. The patient improved and gained full consciousness within 4 days.Three years after the initial trauma, the patient has remained well. This case required a thorough discussion of the surgical options, in particular whether to intervene with the associated cyst, and whether any intervention with the cyst should be performed in the same or future operations. This dilemma forms the basis of the discussion in the following report.

Long-term surgical results with aneurysms involving the ophthalmic segment of the carotid artery

2008 ◽  
Vol 108 (6) ◽  
pp. 1200-1210 ◽  
Author(s):  
Antonino Raco ◽  
Alessandro Frati ◽  
Antonio Santoro ◽  
Tommaso Vangelista ◽  
Maurizio Salvati ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Carotid Artery ◽  
Definitive Treatment ◽  
Surgical Morbidity ◽  
Mortality And Morbidity ◽  
Clinical Records ◽  
University Of Rome ◽  
Incomplete Occlusion

Object Because of the anatomical complexity of the paraclinoid region, the surgical treatment of aneurysms arising in the C6 segment of the internal carotid artery is extremely challenging. The authors' aim in this study was to describe the extended clinical follow-up and assess the short-term and long-term effectiveness of surgical treatment for these aneurysms, focusing on the clinical outcome and degree of aneurysm occlusion and recurrence. Methods The authors retrospectively analyzed the clinical records for patients treated surgically between 1973 and 2004 at the University of Rome, “La Sapienza.” Aneurysms were classified into the following 3 groups according to the site where they arose: the anteromedial, anterior or anterolateral, and posteromedial wall of the C6 segment. Results Of the 108 aneurysms in 104 patients treated, 63 (58%) were large or giant. Eighty-eight aneurysms in 84 patients were clipped, 16 underwent a high-flow bypass, 2 were trapped, 1 was wrapped, and 1 was left untreated. The mean follow-up was 126 months; 47 patients had a follow-up of > 10 years. Of the 88 aneurysms that were clipped, 6 (6.8%) had an incomplete occlusion that required an immediate reoperation in 1 case and at 2 years in another. Overall 6 patients (5.8%) had surgery-related permanent complications. Conclusions Mortality and morbidity rates depend mainly on the patient's preoperative Hunt and Hess grade subarachnoid hemorrhage, whereas surgical morbidity principally reflects excessive manipulation of the optic nerve or ischemic problems due to excessive temporary trapping undertaken without adequate neuroprotection. In expert hands, surgery (clipping and bypass procedures) is a definitive treatment for C6 aneurysms and has an acceptable complication rate.

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.

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 EYES CANNOT SEE WHAT THE BRAIN DOES NOT KNOW

2021 ◽  
Vol 5 (4) ◽  
Author(s):  
Aisyah Amirah binti Mohd Zahari ◽  
Firdaus Ujang
Keyword(s):  
Foreign Body ◽  
Ocular Trauma ◽  
Intraocular Foreign Body ◽  
Definitive Treatment ◽  
Full Thickness ◽  
Report Result ◽  
Angle Method ◽  
The Brain ◽  
Metal Foreign Body

Background: Intraocular foreign body (IOFB) is a common ocular trauma and is a leading cause of visual impairment. Majority of the cases reported the occurrence at the workplace and usually related to activities involving metallic objects. Hammering, drilling, explosion and usage of machining tools are among the causes of IOFB. Foreign body in the angle are frequently missed as it is not visualised directly during a routine examination. Thus, a thorough examination which includes gonioscopy and imaging must be done in all penetrating and full thickness cornea laceration cases. Purpose: We report a case of self-sealed full thickness cornea laceration with presence of metal foreign body in the angle. Method: Case Report Result: A 19 year-old boy, presented with right eye discomfort following trauma 1 week prior to presentation. Examination revealed a self-sealed full thickness cornea laceration at 1-2 o’clock with a foreign body found seated on the angle from gonioscopy. A foreign body consist of metal had successfully removed surgically with the facilitation of intraocular magnet. Conclusion: All self-sealed penetrating injury to the eye required a high index of suspicious of intraocular foreign body. An imaging and complete examination with dilated fundus examination and gonioscopy will be helpful to identify the location of foreign body. Hence, definitive treatment will prevent long term complication related to intraocular foreign body.

The Acute Effect of Alcohol on Various Memory Processes

2010 ◽  
Vol 24 (4) ◽  
pp. 249-252 ◽  
Author(s):  
Márk Molnár ◽  
Roland Boha ◽  
Balázs Czigler ◽  
Zsófia Anna Gaál
Keyword(s):  
Low Dose ◽  
Short Term Memory ◽  
Acute Effect ◽  
Long Term Memory ◽  
Term Memory ◽  
Memory Processes ◽  
Different Types ◽  
The Brain ◽  
Legal Consequences

This review surveys relevant and recent data of the pertinent literature regarding the acute effect of alcohol on various kinds of memory processes with special emphasis on working memory. The characteristics of different types of long-term memory (LTM) and short-term memory (STM) processes are summarized with an attempt to relate these to various structures in the brain. LTM is typically impaired by chronic alcohol intake but according to some data a single dose of ethanol may have long lasting effects if administered at a critically important age. The most commonly seen deleterious acute effect of alcohol to STM appears following large doses of ethanol in conditions of “binge drinking” causing the “blackout” phenomenon. However, with the application of various techniques and well-structured behavioral paradigms it is possible to detect, albeit occasionally, subtle changes of cognitive processes even as a result of a low dose of alcohol. These data may be important for the consideration of legal consequences of low-dose ethanol intake in conditions such as driving, etc.

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