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

Liby, Petr
Author Liby, Petr ORCID Department of Neurosurgery, Second Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, 150 06, Prague 5, Czech Republic. petr.liby@fnmotol.cz
Torres, V L
Author Torres, V L Universidade de Pernambuco (UPE), Recife, Pernambuco, Brazil
Taborsky, J
Author Taborsky, J Department of Neurosurgery, Second Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, 150 06, Prague 5, Czech Republic
Kyncl, M
Author Kyncl, M Department of Radiology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
Tichy, M
Author Tichy, M Department of Neurosurgery, Second Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, 150 06, Prague 5, Czech Republic

Child's nervous system. 2018 Nov ; 34 (11) : 2309-2312. [epub] 20180530

Childs Nerv Syst
ISSN 1433-0350 | 0256-7040
Source

Language English Country Germany Media print-electronic

Document type Case Reports, Journal Article

Persistent link https://www.medvik.cz/link/pmid29846773

PubMed 29846773
DOI 10.1007/s00381-018-3847-1
PII: 10.1007/s00381-018-3847-1
Knihovny.cz E-resources

Keywords
Electromagnetic neuronavigation, Endoscopic third ventriculostomy, Neuroendoscopy, Posterior fossa cyst, Transaqueductal fenestration,
MeSH
Arachnoid Cysts complications surgery MeSH
Electromagnetic Phenomena MeSH
Hydrocephalus etiology surgery MeSH
Humans MeSH
Neuroendoscopy methods MeSH
Neuronavigation methods MeSH
Child, Preschool MeSH
Third Ventricle surgery MeSH
Ventriculostomy methods MeSH
Check Tag
Humans MeSH
Male MeSH
Child, Preschool MeSH
Publication type
Journal Article MeSH
Case Reports MeSH

INTRODUCTION: 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. CASE REPORT: 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. CONCLUSION: 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.

Department of Neurosurgery 2nd Faculty of Medicine Charles University and Motol University Hospital 5 Úvalu 84 150 06 Prague 5 Czech Republic

Department of Radiology 2nd Faculty of Medicine Charles University and Motol University Hospital Prague Czech Republic

Universidade de Pernambuco Recife Pernambuco Brazil

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