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Ho AL, Pendharkar AV, Sussman ES, et al. Dual-trajectory Approach for Simultaneous Cyst Fenestration and Endoscopic Third Ventriculostomy for Treatment of a Complex Third Ventricular Arachnoid Cyst. Cureus. 2015;7(3):e253doi: 10.7759/cureus.253.
Ho, A. L., Pendharkar, A. V., Sussman, E. S., Ravikumar, V. K., & Li, G. H. (2015). Dual-trajectory Approach for Simultaneous Cyst Fenestration and Endoscopic Third Ventriculostomy for Treatment of a Complex Third Ventricular Arachnoid Cyst. Cureus, 7(3), e253. https://doi.org/10.7759/cureus.253
Ho, Allen L, et al. "Dual-trajectory Approach for Simultaneous Cyst Fenestration and Endoscopic Third Ventriculostomy for Treatment of a Complex Third Ventricular Arachnoid Cyst." Cureus vol. 7,3 (2015): e253. doi: https://doi.org/10.7759/cureus.253
Ho AL, Pendharkar AV, Sussman ES, Ravikumar VK, Li GH. Dual-trajectory Approach for Simultaneous Cyst Fenestration and Endoscopic Third Ventriculostomy for Treatment of a Complex Third Ventricular Arachnoid Cyst. Cureus. 2015 Mar 05;7(3):e253. doi: 10.7759/cureus.253. eCollection 2015 Mar. PMID: 26180677; PMCID: PMC4494513.
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Cureus. 2015 Mar 05;7(3):e253. doi: 10.7759/cureus.253. eCollection 2015 Mar.

Dual-trajectory Approach for Simultaneous Cyst Fenestration and Endoscopic Third Ventriculostomy for Treatment of a Complex Third Ventricular Arachnoid Cyst.

Cureus

Allen L Ho, Arjun V Pendharkar, Eric S Sussman, Vinod K Ravikumar, Gordon H Li

Affiliations

  1. Department of Neurosurgery, Stanford University School of Medicine.
  2. Department of Neurosurgery, Stanford University Medical Center.
  3. Department of Neurosurgery, Stanford School of Medicine/Stanford University Medical Center.

PMID: 26180677 PMCID: PMC4494513 DOI: 10.7759/cureus.253

Abstract

OBJECTIVES: We present a case of a multiloculated third ventricular arachnoid cyst to describe a novel technique for definitive management of these lesions via direct endoscopic fenestration and CSF diversion utilizing separate trajectories that offers superior visualization and avoids forniceal injury.

METHODS AND RESULTS: We present a case of a 33-year-old woman with progressive headache and worsened vision, a known history of a multiloculated third-ventricular arachnoid cyst, and imaging findings consistent with cyst expansion and worsened obstructive hydrocephalus. We then describe the dual-trajectory approach for simultaneous cyst fenestration and endoscopic third ventriculostomy that ultimately resulted in successful treatment of her cyst and hydrocephalus.

CONCLUSIONS: Dual-trajectory endoscopic approach utilizing double burr holes should be considered when addressing lesions of the third ventricle causing obstructive hydrocephalus.

Keywords: arachnoid cyst; burrhole; endoscopic third ventriculostomy; hydrocephalus; image guidance

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