| Summary: | Sylvian fissure arachnoid cysts are known intracranial lesion in pediatric population. We describe a case of symptomatic cyst of Sylvian fissure that was managed with a standard endoscopic cystocisternostomy and re-endoscopy.We also describe the techniques of fenestration of medial wall cyst and partial removal of arachnoid membrane over third cranial nerve in anterior part (region near Dolenc medial triangle) and posterior part (region near Fukushima superior (paramedial) triangle) prevent closure of fenestration and recurrence of hypertension.A 6 years old girl presented with progressively increasing headache, left side hemiparesis, drag resistant of symptomatic epilepsy. MRI and CT scan showed right Sylvian fissure arachnoid cyst.The first endoscopic fenestration of cyst was done on standard basis. After operation patient improve clinically and radiologically. Two years later the patient came back with recurrent symptoms. The operation was performed by prof. Sufianov A. Endoscopic reoperation showed closure of fenestration in arachnoid membrane. Endoscopic re-fenestration with partial excision of arachnoid on over third cranial nerve in anterior and posterior part was excised. The patient again recovered radiologically and clinically till last follow up.In Sylvian fissure arachnoid cysts, endoscopic treatment with wide fenestration of medial wall of cyst preferably with partial removal of arachnoid may be very useful and preventing recurrent symptoms. Keywords: Endoscopic fenestration of cyst, Endoscopic cystocisternostomy, Sylvian fissure arachnoid cyst, Redo surgery, Endoscopic technique
|
|---|
