Intracranial congenital arachnoid cysts are benign intra-arachnoidal fluid collections with a wall composed of arachnoid cells encompassing a cavity containing a fluid similar to cerebrospinal fluid. This cavity frequently communicates with the subarachnoid space. Arachnoid cysts are reported to account for about 1% of all intracranial space-occupying lesions. The most frequent localization of congenital intracranial arachnoid cysts is in the middle cranial fossa, constituting more than half of the cases reported in the literature. We report our use of a fully endoscopic supraorbital approach through the eyebrow for accessing and resecting congenital middle cranial fossa arachnoid cysts. The approach was performed on 2 patients, a 9-month-old infant and a 12-year-old female patient. In both cases, the cysts were resected in their entirety utilizing a 1-cm ‘keyhole’ craniotomy, without the need for a corticotomy and with virtually no brain retraction. The outcomes were favorable and both patients were discharged from hospital within 48 h of surgery. There were no perioperative complications and the cosmetic outcomes were excellent.

Keywords:
Endoscopy, Supraorbital resection, Eyebrow, Skull base, Arachnoid cyst, Middle fossa
1.
Brackett CE, Rengachary SS: Arachnoid cysts; in Youmans JR (ed): Neurological Surgery, ed 2. Philadelphia, Saunders, 1982, pp 1436–1446.
2.
Caemaert J, Abdullah J, Calliauw L, Carton D, Dhooge, Coster R: Endoscopic treatment of suprasellar arachnoid cysts. Acta Neurochir (Wien) 1992;119:68–73.
3.
Santamarta D, Aguas J, Ferrer E: The natural history of arachnoid cysts: endoscopic and cine-mode MRI evidence of a slit-valve mechanism. Minim Invasive Neurosurg 1995;38:133–137.
4.
Schroeder HW, Gaab MR: Endoscopic observation of a slit-valve mechanism in suprasellar prepontine arachnoid cyst: case report. Neurosurgery 1997;40:198–200.
5.
Choi JU, Kim DS, Huh R: Endoscopic approach to arachnoid cyst. Childs Nerv Syst 1999;15:285–291.
6.
Wester K: Peculiarities of intracranial arachnoid cysts: location, sidedness, and sex distribution in 126 consecutive patients. Neurosurgery 1999;45:775–779.
7.
Catala M, Poirier J: Arachnoid cysts: histologic, embryologic and physiopathologic review. Rev Neurol (Paris) 1998;154:489–501.
8.
Starkman SP, Brown TC, Linell SA: Cerebral arachnoid cysts. J Neuropathol Exp Neurol 1958;17:484–500.
9.
Robinson RG: The temporal lobe agenesis syndrome. Brain 1964;88:87–106.
10.
Menezes AH, Bell WE, Perret GE: Arachnoid cysts in children. Arch Neurol 1980;37:168–172.
11.
Harsh IV GR, Edwards MSB, Wilson CB: Intracranial arachnoid cysts in children. J Neurosurg 1986;64:835–842.
12.
Dei-Anang K, Voth D: Cerebral arachnoid cysts: a lesion of the child’s brain. Neurosurg Rev 1989;12:59–62.
13.
Anderson FM, Segall HD, Caton WL: Use of computerized tomography scanning in supratentorial arachnoid cysts. J Neurosurg 1979;50:333–338.
14.
Kabil MS, Shahinian HK: Application of the supraorbital endoscopic approach to tumors of the anterior cranial base. J Craniofac Surg 2005;16:1070–1075.
© 2007 S. Karger AG, Basel
2007
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