{"id":"837555ac-85c4-45eb-b49a-2b34093c24fe","slug":"neuronavigation-guided-endoscopic-and-hodotopic-approach-to-an-arachnoid-cyst","title":"Neuronavigation-guided endoscopic and hodotopic approach to an arachnoid cyst","authors":["Zamzuri Idris","Puneet Nandrajog","Jafri M. Abdullah","Rahman I Ghani","Badrisyah Idris"],"abstract":"Background: Arachnoid cysts are intraarachnoid benign cystic lesions filled with cerebrospinal fluid and should be treated without incurring further morbidity to the patients. Case Description: The authors present a case of a 68-year-old elderly female with a large right fronto-parieto-temporal arachnoid cyst who has been suffering from mild left hemiparesis for the past 4 years and presented with sudden onset of seizures. The 3 Tesla MR system with diffusion tensor imaging (DTI) and MR tractography of the brain showed a large right fronto-parieto-temporal cystic lesion measuring 7 × 5 × 5 cm with a midline shift of 1 cm, suggestive of an arachnoid cyst with surrounding ipsilateral white matter projection pathways and inferior occipito-frontal fasciculus or inferior longitudinal white matter tracts. The cyst was successfully treated with neuronavigation-guided endoscopic and hodotopical approach to fenestrate the arachnoid cyst into the sylvian cistern, avoiding inadvertent injury to major white matter tracts portrayed by DTI. Postoperatively, a repeated computed tomography (CT) scan of the brain revealed a smaller arachnoid cyst with correction of the midline shift. The patient was weaned off from the ventilator and her hemiplegia improved gradually. Conclusion: This case report emphasizes the value of neuronavigation-guided endoscopic and hodotopic approach to fenestrate the intra-axial arachnoid cyst.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/837555ac-85c4-45eb-b49a-2b34093c24fe/featured/hero-1782421038624.png","publishDate":"2013-09-19T00:00:00.000Z","doi":"10.4103/2152-7806.118492","categories":["Original Article"],"fullTextUrl":"http://sni.wpengine.com/wp-content/uploads/2015/05/3779/SNI-4-120.pdf"}