Electromagnetic navigation-guided neuroendoscopic transfrontal transaqueductal fenestration of expansive posterior fossa arachnoid cyst with simultaneous endoscopic third ventriculostomy in an infant

Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery
Petr LibyM Tichy

Abstract

We present an infant with an expansive posterior fossa arachnoid cyst and severe clinical deterioration due to decompensated obstructive hydrocephalus. Given the dilated Sylvius aqueduct, we favoured the endoscopic transfrontal transaqueductal route to approach the cyst. A 12-month-old boy was acutely admitted for severe symptoms of intracranial hypertension. Imaging revealed spacious cystic formation in the posterior fossa with expansive behaviour towards the brain stem, fourth ventricle and cerebellum associated with obstructive triventricular hydrocephalus. The patient underwent electromagnetically navigated transfrontal transaqueductal cyst fenestration with simultaneous ETV from two precoronal trajectories with a rigid endoscope. A transaqueductal approach with a rigid endoscope is rarely published, and we were amazed by the impact on the child's clinical improvement after this minimally invasive endoscopic procedure. The case is well documented with imaging and perioperative neuroendoscopic views.

References

Sep 24, 1999·Neurosurgery·H W Schroeder, M R Gaab
Jul 10, 2004·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Henry W S SchroederMichael R Gaab
Aug 19, 2004·Pediatric Radiology·Marvin D NelsonFloyd H Gilles
Jan 1, 2014·Neurosurgery·Jaime Torres-CorzoLeonardo Rangel-Castilla

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Citations

Dec 7, 2019·Neurosurgical Review·Michael G Z Ghali

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