Numbers
- are uncommon
Classification
- Type I
- Cysts with supratentorial and infratentorial extension
- Type II
- Cysts with infratentorial extension (supracerebellar or supra-retrocerebellar)
- Type III
- Cysts with lateral extension toward the temporal lobe.
Clinical presentation
- HCP
- As quadrigeminal arachnoid cysts compress or distort the cerebral aqueduct at an early stage
- Macrocrania
- Headaches
- Vomiting
- Lethargy
- Papilledema
- Parinauds
Management
- Conservative
- Surgical
- Indication
- Symptomatic
- Due to the compressive symptoms produced by these cysts, it is imperative that they be treated.
- Minimally invasive treatment of these cysts is preferred due to their precarious proximity to the pineal quadrigeminal region.
- Endoscopic
- used varies according to the extension of the cyst.
- It can extend to the trigone superiorly, to the supracerebellar cistern inferiorly, and to the third ventricle anteriorly.
- cyst fenestration
- Cyst removal via the suboccipital supracerebellar approach,
- Lateral ventriclecystostomy
- Third ventriclecystostomy
- ETV should be combined with ventriculocystostomy to offer the highest success rate with a single procedure
- Microsurgical
- Outcomes
- Endoscopic approaches
- shunt independent in 78% - 93%
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