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30 Jun 2024 (Vol 47 , Iss 06 )

Journal ID : TMJ-06-02-2023-11499
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Title : Case Series and literature review: Intraventricular Cysts and Hydrocephalus Undergoing Cystoventriculostomy and VP Shunt Procedures

Abstract :

Intraventricular cysts, also known as intraventricular arachnoid cysts or intraventricular cerebrospinal fluid cysts, are rare cases and usually show asymptomatic to symptomatic intracranial Pressure elevation. Intracranial intraventricular cyst is a collection of clear fluid and does not resemble cerebrospinal fluid (CSF) that occurs in the ventricles. Intraventricular cysts are generally treated with open surgery such as peritoneal shunting, microfenestration with partial excision, endoscopic fenestration, stereotactic aspiration cystocisternostomy, and cystoventriculostomy. Endoscopic cystoventriculostomy has become common in recent years, due to its successful operation without touching the basal cistern in most cases with minimal complications. Objectives of this study reports a case series and literature review: patients with intraventricular cysts and hydrocephalus who underwent cystoventriculostomy and VP shunt procedures. We prospectively identified patients with intraventricular cysts who developed hydrocephalus who required a cystoventriculostomy procedure. Patients were followed up for development of hydrocephalus, need for a VP shunt, and length of stay in the intensive care unit. The first case was a 1 year old child with a history of communicating hydrocephalus with a VP shunt, with complaints of vomiting, restlessness, and difficulty sleeping. The results of the head MRI with contrast showed that there were multiloculated cystic lesions in the III and IV ventricles. The second case was a 79-year-old man with complaints of seizures and a history of decreased consciousness. A CT scan of the head revealed a cystic lesion with rim of calcification in the left frontal lobe. Both patients underwent endoscopic fenestration with good outcome in both patients. Although the arachnoid cyst is a relatively benign pathological entity, preemptive therapy can be managed with endoscopically guided fenestration of the cyst wall. Endoscopic fenestration is the technique of choice because the risks and complications associated with open craniotomy and fenestration are less.

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