J Neurol Surg A Cent Eur Neurosurg 2022; 83(01): 085-088
DOI: 10.1055/s-0041-1726109
Technical Note

Robot-Assisted Stereotactic Shunting as a Novel Treatment for Pontine Glioependymal Cysts

Simon Schieferdecker
1   Department of Medicine, Heinrich Heine University Düsseldorf, Dusseldorf, Nordrhein-Westfalen, Germany
,
Stefan Hunsche
2   Department of Stereotactic and Functional Neurosurgery, Cologne Merheim Medical Center (CMMC), Cologne, Germany
,
Faycal El Majdoub
2   Department of Stereotactic and Functional Neurosurgery, Cologne Merheim Medical Center (CMMC), Cologne, Germany
,
Mohammad Maarouf
3   Department of Neurosurgery, Beta Clinic Bonn, Bonn, Germany
› Author Affiliations

Abstract

In this case report, the authors describe the first case of a glioependymal cyst of the brainstem managed by robot-assisted, stereotactic, cysto-ventricular shunting. Glioependymal cysts are rare congenital cystic lesions that are thought to form by displacement of ependymal cells during the embryonal period. Glioependymal cysts have been reported in a variety of different locations within the central nervous system. However, glioependymal cysts of the brainstem have only been described once before. Here, we report the case of a 53-year-old man who was referred to our department due to hemiparesis, hemihypesthesia, and hemidysesthesia, as well as facial and abducens nerve palsy. A large pontine glioependymal cyst was confirmed via magnetic resonance imaging (MRI) scans. The cyst was subsequently decompressed by connecting the cyst with the fourth ventricle via robot-assisted stereotactic shunt placement. In the postoperative course, the patient made a quick recovery and did not report any permanent neurologic deficits.



Publication History

Received: 09 July 2020

Accepted: 28 October 2020

Article published online:
24 May 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Friede RL, Yasargil MG. Supratentorial intracerebral epithelial (ependymal) cysts: review, case reports, and fine structure. J Neurol Neurosurg Psychiatry 1977; 40 (02) 127-137
  • 2 Alvarado AM, Smith KA, Chamoun RB. Neuroendoscopic fenestration of glioependymal cysts to the ventricle: report of 3 cases. J Neurosurg 2018; 1–5: 1-5
  • 3 Robles LA, Paez JM, Ayala D, Boleaga-Duran B. Intracranial glioependymal (neuroglial) cysts: a systematic review. Acta Neurochir (Wien) 2018; 160 (07) 1439-1449
  • 4 Davis RP, Sachdev VP, Sachar M. Ependymal cyst of the quadrigeminal plate: case report. Neurosurgery 1985; 16 (01) 96-99
  • 5 Neudorfer C, Hunsche S, Hellmich M, El Majdoub F, Maarouf M. Comparative study of robot-assisted versus conventional frame-based deep brain stimulation stereotactic neurosurgery. Stereotact Funct Neurosurg 2018; 96 (05) 327-334
  • 6 Lefranc M, Le Gars D. Robotic implantation of deep brain stimulation leads, assisted by intra-operative, flat-panel CT. Acta Neurochir (Wien) 2012; 154 (11) 2069-2074
  • 7 Lefranc M, Capel C, Pruvot-Occean AS. et al. Frameless robotic stereotactic biopsies: a consecutive series of 100 cases. J Neurosurg 2015; 122 (02) 342-352
  • 8 Boockvar JA, Shafa R, Forman MS, O'Rourke DM. Symptomatic lateral ventricular ependymal cysts: criteria for distinguishing these rare cysts from other symptomatic cysts of the ventricles: case report. Neurosurgery 2000; 46 (05) 1229-1232 , discussion 1232–1233
  • 9 Borghei-Razavi H, Das P, Kshettry V. Left supraorbital eyebrow approach for microscopic fenestration of a neuroglial cyst. World Neurosurg 2018; 118: 161
  • 10 Apra C, Law-Ye B, Leclercq D, Boch AL. Needle aspiration as an alternative treatment for glio-ependymal cysts. Acta Neurochir (Wien) 2018; 160 (10) 2007-2008
  • 11 Brandmeir NJ, Savaliya S, Rohatgi P, Sather M. The comparative accuracy of the ROSA stereotactic robot across a wide range of clinical applications and registration techniques. J Robot Surg 2018; 12 (01) 157-163