2024-03-29T15:03:26Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:02001450
2023-11-16T01:55:49Z
499:508:509:1631753421512
Surgical strategy for symptomatic pineal cyst: is endoscopit third ventriculostomy necessary in addition to cyst fenestration?
Ndukuba, Kelechi
Ogiwara, Toshihiro
Nakamura, Takuya
Kamiya, Keisuke
Hanaoka, Yoshiki
Horiuchi, Tetsuyoshi
Ohaegbulam, Samuel
Hongo, Kazuhiro
open access
Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
pineal cyst
cyst fenestration
hydrocephalus
neuroendoscopy
endoscopic third ventriculostomy
Symptomatic large pineal cyst (PC) remains a rare entity. The stable natural course of asymptomatic PCs is well established. However, large cysts may cause pressure-related symptoms necessitating surgical intervention. The surgical strategy for symptomatic PCs is still controversial. Regardless of the approach, total resection of the cyst is not mandatory. The endoscopic approach allows cyst fenestration in patients with associated obstructive hydrocephalus. On the other hand, the necessity of simultaneous endoscopic third ventriculostomy (ETV) is still debatable. Here, we report a case of a woman who underwent endoscopic cyst fenestration, biopsy, and third ventriculostomy for a large symptomatic PC and discuss the surgical strategy. A 30-year-old woman presented with headache and diplopia, MRI showed a large PC and ac- companying obstructive hydrocephalus. Simultaneous cyst fenestration, biopsy and ETV with endoscopy was successfully completed. She had an uneventful recovery period with immediate relief of symptoms. Although, the aqueduct was communicated due to cyst shrinkage, the patency of the third ventricular stoma was demonstrated in long-term follow-up scans. Based on clinical course of the present case, we concluded that ETV in addition to cyst fenestration should be considered necessary and beneficial in cases of large symptomatic PC with associated hydrocephalus whenever an endoscopic intraventricular approach is considered.
Nagoya University Graduate School of Medicine, School of Medicine
2021-08
eng
departmental bulletin paper
VoR
https://doi.org/10.18999/nagjms.83.3.627
http://hdl.handle.net/2237/0002001450
https://nagoya.repo.nii.ac.jp/records/2001450
10.18999/nagjms.83.3.627
https://www.med.nagoya-u.ac.jp/medlib/nagoya_j_med_sci/833.html
0027-7622
2186-3326
Nagoya Journal of Medical Science
83
3
627
633
https://nagoya.repo.nii.ac.jp/record/2001450/files/17_Ndukuba.pdf
application/pdf
7.1 MB
2021-09-16