Abstract
The authors report a case study of a giant cyst of the cavum septi pellucidi, cavum
Vergae and veli interpositi spreading to the posterior fossa, and initially treated
elsewhere by ventriculoperitoneal shunt, with no resolution of the symptomatology.
A few months later the patient was successfully treated by fenestration into the ventricular
system through a neuroendoscopic technique, at the Pediatric Neurosurgical Center
of the Meyer Children's Hospital in Florence. Symptomatic midline cysts are quite
rare and different techniques have been proposed for their treatment, i. e., direct
craniotomy, conventional shunting, stereotactic approaches as well as endoscopic fenestration.
In such cases neuroendoscopy obtains a good symptom resolution level, avoiding at
the same time the risks of damage to endoventricular structures and often eliminates
the need for a definitive ventriculoperitoneal shunt. In the present research the
authors analyze the anatomy of the midline cavities and the mechanism through which
a cyst may become symptomatic. The surgical endoscopic technique and the clinical
and radiological assessments which confirmed the patency of the fenestration are also
discussed. The authors conclude that endoscopic ventricular fenestration may represent
the treatment of choice for this pathology.
Key words
Neuroendoscopy - midline cavities - intracranial cysts
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Dr. P. Donati
Pediatric Neurosurgical Center · Children's Hospital “A. Meyer”
Via L. Giordano, 13
50132 Firenze · Italy
Telefon: +39-055566-2449
Fax: +39-05557-6200
