A case of obstructive hydrocephalus caused by arachnoid cyst and successfully treated by endoscopic third ventriculostomy

Masaya Haruka, Yamamoto Tatsuya, Asari Arisa, Ito Tatsuya, Katayama Kosuke, Yagi Hiroko, Terui Kiminori

doi:10.32216/hirosakiigaku.72.1-4_76

Although arachnoid cysts are generally asymptomatic and are often detected incidentally by imaging studies, they have been reported to cause obstructive hydrocephalus, endocrine disorders, and visual dysfunction in rare cases. In this study, we report a case of obstructive hydrocephalus caused by an arachnoid cyst, which responded well to endoscopic third ventriculostomy. The patient was a 3-year-old boy who was referred to our department with the chief complaint of vomiting, gait disturbance, and abnormal eye position. An MRI scan showed hydrocephalus and a cystic mass close to the cerebral aqueduct. Cystectomy and endoscopic third ventriculostomy were performed. After the surgery, the symptoms gradually improved, and the hydrocephalus tended to improve on imaging examinations. Based on the intraoperative findings and the results of the pathological examination, the cystic mass was diagnosed as an arachnoid cyst originating from the third ventricle, and it was considered that the arachnoid cyst caused the obstructive hydrocephalus. Most arachnoid cysts are asymptomatic; however, if they are found incidentally on imaging studies, the younger the patient, the more likely they are to spontaneously enlarge and cause obstructive hydrocephalus. Thus, arachnoid cysts in children should be followed up carefully.

A case of obstructive hydrocephalus caused by arachnoid cyst and successfully treated by endoscopic third ventriculostomy

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