Giannetti Alexandre Varella, Fraga Sílvia Maria Ferreira, Silva Márcia Cristina, Gurgel-Giannetti Juliana
Department of Neurosurgery, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Pediatr Neurosurg. 2012;48(3):157-62. doi: 10.1159/000346263. Epub 2013 Feb 8.
To describe the neuroendoscopic treatment of interhemispheric arachnoid cysts.
Five children (aged 1-9 months) harboring interhemispheric arachnoid cysts underwent the procedure. The neuroendoscopic technique included cystoventriculostomy and cystocisternostomy. Imaging exams were compared before and after surgery, and the differences in cyst diameters were calculated. Head circumference and neurological development were also evaluated.
The cystoventriculostomy was performed through the lateral ventricle in 4 cases and through the third ventricle in 4 cases. An added cystocisternostomy was performed in 1 case. Cyst diameters were reduced in the anterior-posterior, lateral-medial and superior-inferior planes in 22, 31 and 31% of the cases, respectively. The rate of increasing head circumference slowed; however, all the children continued to show slight macrocrania. There were complications in 2 cases: cerebrospinal fluid fistula was managed by lumbar puncture in 1 case and subdural collection was treated with a shunt in another single case.
The neuroendoscopic approach to interhemispheric arachnoid cysts was effective with few complications.
描述经神经内镜治疗大脑半球间蛛网膜囊肿。
对5例（年龄1 - 9个月）大脑半球间蛛网膜囊肿患儿进行了该手术。神经内镜技术包括囊肿脑室造瘘术和囊肿脑池造瘘术。对比手术前后的影像学检查结果，计算囊肿直径的差异。同时评估头围和神经发育情况。
4例经侧脑室进行囊肿脑室造瘘术，4例经第三脑室进行。1例加做了囊肿脑池造瘘术。分别有22%、31%和31%的病例囊肿直径在前后、内外和上下平面缩小。头围增长速度减慢；然而，所有患儿仍有轻度巨头畸形。2例出现并发症：1例脑脊液漏经腰椎穿刺处理，另1例硬膜下积液行分流治疗。
经神经内镜治疗大脑半球间蛛网膜囊肿有效，并发症少。
