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. 2023 Sep;165(9):2561-2565.
doi: 10.1007/s00701-023-05531-8. Epub 2023 Feb 27.

Microscope neuronavigation-guided microsurgical fenestration of quadrigeminal cistern arachnoid cysts: how I do it

Luca Campagnaro  1 , Camilla Bonaudo  2 , Federico Capelli  2 , Alessandro Della Puppa  2
Affiliations

Microscope neuronavigation-guided microsurgical fenestration of quadrigeminal cistern arachnoid cysts: how I do it

Luca Campagnaro et al. Acta Neurochir (Wien). 2023 Sep.

Abstract

Background: Management options for treatment of quadrigeminal arachnoid cysts (QAC) include microsurgical/endoscopic fenestration or shunt. There is an open debate about which method is the best. Microsurgical fenestration is well suited for treatment of QAC with predominant infratentorial component and without hydrocephalus making endoscopic procedures more challenging.

Method: We describe the microsurgical technique and related anatomy to fenestrate infratentorial QAC through supracerebellar infratentorial approach. We also discuss our experiences with this approach, some of the drawbacks and nuances.

Conclusion: Navigation-guided microsurgical fenestration of infratentorial QAC is the authors' surgical approach of choice for treating these rare challenging lesions when not associated with hydrocephalus.

Keywords: Arachnoid cyst; Microsurgical cyst fenestration; Pineal region; Supracerebellar infratentorial approach.

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