Skip to main content
SpringerLink
Log in

Stereotactic management of congenital midline cysts

  • Clinical Articles
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

The treatment of congenital midline cysts remains a controversial issue. The Stereotactic management of 27 patients (6 symptomatic cavum septi pellucidi/cavum Vergae, 6 suprasellar cysts, 5 intraventricular cysts, 4 parasagittal cysts, and 6 supracollicular cysts) is reviewed. In 23 patients Stereotactic ventriculo-cystostomy by catheter implantation (internal drainage) led to clinical recovery or improvement accompanied by decreased cyst size. In four patients the internal drainage was not sufficient and was therefore completed as a ventriculo-atrial shunt system. Three minor complications (bleeding, aseptic meningitis, catheter infection) led to no sequelae. The results suggest that Stereotactic internal drainage of these benign lesions is a safe, minimally invasive and efficient procedure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Aicardi J, Baumann F (1975) Supratentorial extracerebral cysts in infants and children. J Neurol Neurosurg Psychiatry 38: 57–68

    PubMed  Google Scholar 

  2. Amin BH (1986) Symptomatic cyst of the septum pellucidum. Childs Nerv Syst 2: 320–322

    PubMed  Google Scholar 

  3. Anderson FM Segall HD, Caton WL (1979) Use of computerized tomography scanning in supratentorial arachnoid cysts. J Neurosurg 50: 333–338

    PubMed  Google Scholar 

  4. Bruyn GW (1977) Agenesis septi pellucidi, cavum septi pellucidi, cavum Vergae, and cavum veli interpositi. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, Vol 30. Elsevier, Amsterdam, pp 299–336

    Google Scholar 

  5. Cillufo M, Onofrio BM, Ritter RH (1983) The diagnosis and surgical treatment of intracranial arachnoid cysts. Acta Neurochir (Wien) 67: 215–229

    Google Scholar 

  6. Dandy WE (1931) Congenital cerebral cysts of the cavum septi pellucidi (fifth ventricle) and cavum vergae (sixth ventricle). Diagnosis and treatment. Arch Neurol Psychiatry 25: 44–66

    Google Scholar 

  7. Davis RP, Sachdev VP, Sachar M (1985) Ependymal cyst of the quadrigeminal plate: case report. Neurosurgery 16: 96–99

    PubMed  Google Scholar 

  8. Di Rocco C (1990) Arachnoid cysts. In: Youmans JR (ed) Neurological surgery. Saunders, Philadelphia, pp 1299–1325

    Google Scholar 

  9. Donauer E, Moringlane JR, Ostertag CB (1986) Cavum vergae cysts as a cause of hydrocephalus, “almost forgotten”? Acta Neurochir (Wien) 83: 12–19

    Google Scholar 

  10. Dyck P, Gruskin P (1977) Supratentorial arachnoid cysts in adults. A discussion of two cases from a pathophysiologic and surgical perspective. Arch Neurol 34: 276–279

    PubMed  Google Scholar 

  11. Friede RL, Yaşargil MG (1977) Supratentorial intracerebral epithelial (ependymal) cyst. J Neurol Neurosurg Psychiatry 40: 127–137

    PubMed  Google Scholar 

  12. Galassi E, Piazza G, Gaist G,et al (1980) Arachnoid cysts of the middle cranial fossa: a clinical and radiological study of 25 cases treated surgically. Surg Neurol 14: 211–219

    PubMed  Google Scholar 

  13. Geissinger JD, Kohler WC, Robinson BW,et al (1978) Arachnoid cysts of the middle cranial fossa. Surgical considerations. Surg Neurol 10: 27–33

    PubMed  Google Scholar 

  14. Go KG, Houthoff HJ, Blaauw EH,et al (1984) Arachnoid cysts of the Sylvian Gssure. Evidence of fluid secretion. J Neurosurg 60: 803–813

    PubMed  Google Scholar 

  15. Haddad FS, Abla A, Allam C (1982) Ependymal brain cyst. Surg Neurol 18: 246–249

    PubMed  Google Scholar 

  16. Harsh IV GH, Edwards MSB, Wilson CB (1986) Intracranial arachnoid cysts in children. J Neurosurg 64: 835–842

    PubMed  Google Scholar 

  17. Hoffman HJ, Hendrick EB, Humphreys RP,et al (1982) Investigation and management of suprasellar arachnoid cysts. J Neurosurg 57: 597–602

    PubMed  Google Scholar 

  18. Hume Adams J, Corsellis JAN, Duchen LW (1984) Greenfields neuropathology, 4th Ed. Arnold, London, pp 426–427

    Google Scholar 

  19. Jeeves MA, Simpson DA, Geffen G (1979) Functional consequences of the transcallosal removal of intraventricular tumours. J Neurol Neurosurg Psychiatry 42: 134–142

    PubMed  Google Scholar 

  20. Kaplan BJ, Mickle JP, Parkhurst R (1984) Cystoperitoneal shunting for congenital arachnoid cysts. Childs Brain 11: 304–311

    PubMed  Google Scholar 

  21. Krawchenko J, Collins GH (1979) Pathology of an arachnoid cyst. Case report. J Neurosurg 50: 224–228

    PubMed  Google Scholar 

  22. Lange M, Oeckler R, Beck OJ (1990) Surgical treatment of patients with midline arachnoid cysts. Neurosurg Rev 13: 35–39

    PubMed  Google Scholar 

  23. Miller D (1949) Cyst of the fifth ventricle treated by intraventricular drainage. J Neurosurg 6: 332–333

    Google Scholar 

  24. Murali R, Epstein F (1979) Diagnosis and treatment of suprasellar arachnoid cysts. Report of three cases. J Neurosurg 50: 515–518

    PubMed  Google Scholar 

  25. Nakase H, Hisanaga M, Hashimoto S,et al (1988) Intraventricular arachnoid cyst. J Neurosurg 68: 482–486

    PubMed  Google Scholar 

  26. Nötzel H (1940) Arachnoidalzysten in der Cisterna ambiens. Zentralbl Neurochirurgie 5: 281–294

    Google Scholar 

  27. Pierre-Kahn A, Capelle L, Brauner R,et al (1990) Presentation and management of suprasellar arachnoid cysts. Review of 20 cases. J Neurosurg 73: 355–359

    PubMed  Google Scholar 

  28. Raffel C, McComb JG (1988) To shunt or to fenestrate: which is the best surgical treatment for arachnoid cysts in pediatric patients? Neurosurgery 23: 338–342

    PubMed  Google Scholar 

  29. Rengachary SS, Watanabe I (1981) Ultrastructure and pathogenesis of intracranial arachnoid cysts. J Neuropathol Exp Neurol 40: 61–83

    PubMed  Google Scholar 

  30. Rengachary SS, Watanabe I, Brackett CE (1978) Pathogenesis of intracranial arachnoid cysts. Surg Neurol 9: 139–144

    PubMed  Google Scholar 

  31. Robinson RG (1971) Congenital cysts of the brain: arachnoid malformations. Progr Neurol Surg 4: 133–174

    Google Scholar 

  32. Scarff JE (1941) A new method for treatment of cystic craniopharyngioma by intraventricular drainage. Arch Neurol Psychiatry 46: 843–867

    Google Scholar 

  33. Schwidde JT (1952) Incidence of cavum septi pellucidi and cavum vergae in 1032 human brains. Arch Neurol Psychiatry 67: 625–632

    Google Scholar 

  34. Scott M (1945) Cyst of the sixth ventricle (cavum of Verga). Successful removal through transventricular approach with notes on embryology and histopathology. J Neurosurg 2: 191–201

    Google Scholar 

  35. Shaw CM, Alvord EC (1969) Cava septi pellucidi et Vergae: their normal and pathological states. Brain 92: 213–224

    PubMed  Google Scholar 

  36. Smith RA, Smith WA (1976) Arachnoid cysts of the middle cranial fossa. Surg Neurol 5: 246–252

    PubMed  Google Scholar 

  37. Starkman SP, Brown TC, Linell EA (1958) Cerebral arachnoid cysts. J Neuropath Exp Neurol 17: 484–500

    PubMed  Google Scholar 

  38. Stein SC (1981) Intracranial developmental cysts in children: treatment by cystoperitoneal shunting. Neurosurgery 8: 647–650

    PubMed  Google Scholar 

  39. Van Wagenen Wp, Aird RB (1934) Dilatation of the cavity of the septum pellucidum and Cavum vergae. Report of cases. AM J Cancer 20: 539–557

    Google Scholar 

  40. Williams B, Guthkelch AN (1974) Why do central arachnoid pouches expand. J Neurol Neurosurg Psychiatry 37: 1085–1092

    PubMed  Google Scholar 

  41. Wolf A, Bamford TE (1935) Cavum septi pellucidi and cavum vergae. Bull Neurol Inst NY 4: 294–309

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Abteilung Stereotaktische Neurochirurgie, Neurochirurgische Universitätsklinik, Freiburg i. Br., Federal Republic of Germany

    P. Behrens & Ch. B. Ostertag

Authors
  1. P. Behrens
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ch. B. Ostertag
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Behrens, P., Ostertag, C.B. Stereotactic management of congenital midline cysts. Acta neurochir 123, 141–146 (1993). https://doi.org/10.1007/BF01401870

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01401870

Keywords

Search

Navigation