Shevchenko K V, Shimansky V N, Tanyashin S V, Donskoy A D, Karnaukhov V V, Poshataev V K
Burdenko Neurosurgical Center, Moscow, Russia.
Zh Vopr Neirokhir Im N N Burdenko. 2021;85(5):96-102. doi: 10.17116/neiro20218505196.
Arachnoid cysts (AC) are spaces with cerebrospinal fluid covered with arachnoid membrane. Most cysts are supratentorial and only 10-12% of ACs are found in posterior cranial fossa. This disease is usually diagnosed in childhood. In adults, ACs make up 1.4% of all focal lesions. ACs of posterior cranial fossa are often localized behind the cerebellum or in cerebellopontine angle. Most patients with cysts do not have permanent symptoms and should be followed-up. Surgery is indicated for cysts complicated by focal and hydrocephalic-hypertension symptoms. Microsurgical or endoscopic procedures are used. Surgical approach is determined by the closest location of cyst to brain surface. The authors report non-standard surgical approach for giant AC of posterior cranial fossa complicated by obstructive hydrocephalus, intracranial hypertension and visual function impairment. Endoscopic third ventriculostomy was followed by AC fenestration through ventriculostomy. Symptoms disappeared within 6 months after surgery.
蛛网膜囊肿（AC）是充满脑脊液且被蛛网膜覆盖的腔隙。大多数囊肿位于幕上，仅10% - 12%的蛛网膜囊肿位于后颅窝。这种疾病通常在儿童期被诊断出来。在成人中，蛛网膜囊肿占所有局灶性病变的1.4%。后颅窝的蛛网膜囊肿常位于小脑后方或小脑脑桥角。大多数囊肿患者没有永久性症状，应进行随访。对于伴有局灶性和脑积水 - 高血压症状的囊肿，需进行手术治疗。采用显微手术或内镜手术。手术入路取决于囊肿与脑表面的最接近位置。作者报告了一种针对后颅窝巨大蛛网膜囊肿合并梗阻性脑积水、颅内高压和视觉功能损害的非标准手术方法。在内镜下第三脑室造瘘术后，通过脑室造瘘进行蛛网膜囊肿开窗。术后6个月内症状消失。
